[Assessing effectiveness of a cardiac rehabilitation program on outcomes of myocardial infarction]

Cardiovascular diseases are among the major mortality causes world widely. Cardiac rehabilitation reduces cardiovascular mortality and improves cardiovascular and mental status of cardiac patients. The aim of this study was to assess the effectiveness of a cardiac rehabilitation program on myocardial infraction outcome. An experimental study was conducted with a sample of 170 patients [85 patients in each group of experiment and control] with myocardial infraction drawn from Amir Kabir hospital affiliated to Arak University of Medical Sciences. Data was gathered by a questionnaire and an observational check list before and after the intervention for both group. The experiment group participated in two-session cardiac rehabilitation program, once during discharge and one after 2-3 weeks of discharge. Statistical analysis was done by Chi-square test, Fisher's exact test and Ttest. There was a significant relationship between cardiac rehabilitation program and chest pain, dyspnea, fatigue, peripheral edema, palpitation and rehospitalization of patients [P<0.05]. It was demonstrated cardiac rehabilitation program could result less frequent chest pain, dyspnea, fatigue, peripheral edema, palpitation and rehospitalization of the patients as well as quicker normalization of inverted T wave. It calls more attention to cardiac rehabilitation program

[Occupational violence in nursing students in Arak, Iran]

Nursing students are often exposed to verbal abuse and/or physical assaults from patients and patients' families during the course of their training. Although, past studies have explored violence against nurses, a little attention has been paid by researchers to workplace violence against nursing students. The aim of this study is to identify and explore influencing factors on workplace violence in nursing students during their training programs. In this descriptive study, 271 nursing students completed a reliable and valid questionnaire. Participants were working in teaching hospital affiliated to Arak University. In total, 74.9% and 7.38% of the respondents stated that they had been verbally abused and physically assaulted during their training program in the previous 12-months period, respectively. Most of physical attacks were happened by patients whereas most verbal abuses by patients' families. There were no statistically significant differences between sex and different years in violence. Nursing students are often exposed to violence during the course of their training programs. Nursing students require training on how to prevent and respond to workplace violence, and this important topic should be incorporated into the nursing students' curriculum

[Barriers to the reporting of needlestick/sharps injuries among nursing and midwifery students in Arak, Iran]

Nursing and midwifery students are at risk needlestick/sharps injuries [NSIs/Sis]. Actual number of NSIs/SIs among students due to insufficient reporting it is not clear in Iran. The aim of this study was to explore the barriers of not reporting of NSIs/SIs among nursing students. This descriptive cross-sectional study was conducted in Arak University of Medical Sciences in 2009. 207 and 68 nursing and midwifery students were participated in study, respectively. A questionnaire, consisting two sections of demographic information and questions about exposure to [NSIs/SIs] and frequency and barrier reporting of NSIs/SIs, was completed by students. According to the findings, 43% and 20.5% of nursing and midwifery students had experienced at least one contaminated NSIs/Sis in the past 12 months. Only 44.9% [n=40] and 50% [n=7] of the nursing and midwifery who had experienced NSIs/Sis in the previous year, were reported all exposures to NSIs/Sis, respectively. The most important the reasons for not reporting injuries consisted of low probabilities of the infection risk of the injury source, not familiar with reporting process and fear of decreasing evaluation score. NSIs/SIs and non-reporting of NSIs/SIs were highly prevalent in nursing and midwifery students. More education programs should be directed at students to increase their awareness of about NSIs/SIs. Also nursing and midwifery student's instructors should give positive responses to nursing students for reporting NSIs/SIs

[Burn out in caregivers of patients with stroke and its related factors]

Introduction: Most of stroke survivors become dependant to their families for their daily living. However, no attention has been paid to mental and physical status of the caregivers of stroke patients in Iran. The aim of this study was to determine the rate of burn out in caregivers of stroke patients, one and three months after the stroke

Methods: This was a cross-sectional study in which 140 caregivers of stroke patients were recruited to the study from a hospital in Arak. The caregivers completed the Zarit Burden Inventory in hospital, and one and three months after discharge

Results: Most of the caregivers were spouses of the patients [70.71%; n=95]. The mean age of the caregivers was 57.1 years old. Of all caregivers, 30.71%, 48.57% and 20.71% suffered from mild, moderate and severe burn out, respectively at three months after the stroke. The caregivers' burn out was significantly increased at the follow up measurement. The caregivers' burn out was associated with the level of dependency and age of the patients, and also gender and relativity of the caregiver, and the time spent for daily care [p<0.05]

Conclusion: Care of patients with stroke causes caregivers to experience a sense of burn out. Age, level of patient's dependency, gender, relativity, and the time spent on care are associated with the burnout. Appropriate interventions should be implemented to reduce such burn outs

[Impact of teaching cardiac rehabilitation programs on electrocardiogram changes among patients with myocardial infarction]

Cardiovascular diseases are the most common mortality cause world widely. Cardiac rehabilitation can reduce cardiovascular mortality and improves mental and cardiovascular conditions among cardiac patients. The aim of this study was to assess the impact of teaching cardiac rehabilitation program on electrocardiogram changes among patients with myocardial infarction. A semi-experimental study was conducted with 170 patients with myocardial infarction who were randomly allocated in two groups of intervention and control [85 patients in each group], 2008-2009. Participants were hospitalized in one of the hospitals affiliated to Arak University of Medical Sciences. Sample selection lasted 15 months. A cardiac rehabilitation program in two sessions was presented for experiment group. The first session was held at discharge time and the next 2-3 weeks afterward. Content of cardiac rehabilitation program was included a brief introduction to heart anatomy, exercise, controlling and modifying cardiovascular risk factors such as hypertension, diabetes mellitus, hyperlipidemia, diet, sexual relationships, mental health [e.g. Stress management] and medicine regime. Control group just received the regular care, not the rehabilitation program. A 12-lead electrocardiogram was obtained five times during six months. It was revealed that normalizing of inverted t wave after six month in experiment group was significantly more than control group [P<0.05]. Changes of ST segment and Q wave didn't t show any significant differences between experiment and control groups. The study indicated that teaching cardiac rehabilitation program accelerates normalizing inverted t wave. It clearly demonstrates the valuable outcomes of teaching cardiac rehabilitation program to patients with myocardial infarction

[Frequency of risk factors for atherosclerosis in children with family history of premature myocardial infarction]

Clinical manifestations of coronary artery disease such as myocardial infarction generally have onset from middle age onwards. However, studies indicate that the atherosclerotic process begins to develop during childhood. The purpose of this study was to evaluate the frequency of risk factors for atherosclerosis in children with family history of premature myocardial infarction in Arak city in 2007. This was a cross sectional study in which 209 children and adolescents aged 3-18 years with a family history of early onset myocardial infarction were selected base on convenience sampling. Total cholesterol, low density lipoprotein cholesterol [LDL-C], high density lipoprotein cholesterol [HDL-C], triglycerides, blood pressure, weight and height and fasting blood sugar were investigated. Data were analyzed by SPSS. The prevalence of hypercholesterolemia and hypertriglyceridemia were 28.2% and 20.1% respectively. 19.1% of these individuals had HDL-C values lower than 35mg/dL. 19/1% of them had LDL-C levels higher than 129 mg/dL. 4/31% presented hypertension and 28/71% had excessive weight. There was no relationship between hyperlipidemia and fasting blood sugar. However, there was significant association between hyperlipidemia and level of BMI and blood pressure [P<0.05]. More than a quarter of children had at least one risk factor for atherosclerosis. Obesity was identified to be significantly associated with hyperlipidemia. These results emphasis the importance of evaluating children and adolescents with family history of early onset myocardial infarction for atherosclerotic disease

Refusal in reporting medication errors from the viewpoints of nursing students in Arak University of medical sciences

Reporting medication errors leads to saving patients' wellbeing and safety and also is counted as a valuable information source for preventing further mistakes in future. The aim of this study was to determine the causes for refusing to report medication errors from the viewpoints of nursing students. All nursing students of Arak University of Medical Sciences [n=76] were selected to participate in this descriptive cross- sectional study. Using a 17 item questionnaire based on 5-point Lickert scale, nursing students' viewpoints toward refusal in reporting medication errors were investigated. This questionnaire included 3 domains of fear from reporting consequences [10 items], administrative factors [4 items], and reporting procedure [3 items]. Data was analyzed by SPSS software. Nursing students estimated that 75% of medication errors were reported by them. Among all causes under investigation," fear from reporting consequences" had the highest score [4.13] among all. From 10 existing items in the domain of "fear from reporting consequences", "fear from evaluation score", and "academic consequences", were main causes for refusing to report medication errors. Among 4 items in the domain of "administrative factors", students had most agreement with the item of "lack of appropriate feedback following reporting medication fault". Some medication errors are not reported by the students and fear from reporting consequences and administrative factors are two main factors for refusing to report medication errors in nursing students. With regard to the fact that reporting medication errors could enhance the patients' immunity, nursing instructors should react positively towards the reports of medication errors by nursing students

[Medication calculation skills in nursing students of Arak University of Medical Sciences in 2007]

Accurate medication calculation is a critical skill that nurses must demonstrate in order to administer medications safely. However, the ability of nursing students to calculate the correct dasage of medications has been mentioned as a concern in numerous studies. The aim of this study was to investigate the ability of nursing students in medication calculation. In this cross-sectional descriptive study, 76 nursing students were selected. The data gathering tool was a questionnaire consisted of three parts including demographic information, students' views toward their interest and ability in medication calculation, and 20 questions about medication calculation. After gathering the questionnaires, they were analyzed by SPSS software using statistical t-test, ANOVA, and correlation coefficient. According to most students, calculating medication dosage was simple [65.78 percents], they were interested in it [55.26 percents], and they had enough proficiency in performing this activity [63.15 percents]. Six students [7.89 percents] had provided correct answers to all of 20 questions and 33 ones [43.42] had responded to 75 percents of the questions correctly. The mean and standard deviation of students' scores were 14.9 +/- 6.2. There was a significant relationship between the semester and interest in medication calculation, and the test results. Although medication calculation is one of the essential skills for nurses; few participants had provided correct answers to all of the questions. This reveals the importance of this skill and a need to emphasize on medication calculation in nursing students' education

Frequency, type and causes of medication errors In student nurses

Medication errors in healthcare environment are considered as a serious threat to patients' health. The purpose of this study was to investigate the frequency, type and causes of medication errors of nursing students. This was a descriptive study conducted in Arak University of Medical Sciences. Seventy six student were selected through census method of sampling. A questionnaire, consisting two sections of demographic information and questions about medication errors, was completed by students. Data were analyzed using descriptive statistics. According to findings, 17.1% of students reported medication errors and 43.42% reported impending medication errors. The most common type of error was wrong dose of medication, the most common cause of which was poor pharmacologic knowledge. Heparin, Dopamin, Dubotamin, Vancomycin, Phenytoin and Captoprile were the most prevailing drugs about which the students reported errors. Results showed that the rate of medication errors in nursing student was high. It seems that some causes of medication errors are related to poor pharmacological knowledge, drug calculation and so on. According to the results, it is imperative to realize the weak points of students or educational program and plan to resolve them

[Effects of disinfecting meatus and urinary catheter with 10% Povidone Iodine ointment on incidence rate of bacteriuria in hospitalized male patients in neurologic wards]

Urinary tract infection is one of the most common nosocomial infections that mainly occur after instrumentation in urinary tract, particularly after urinary catheterization. This study was conducted to assess disinfection's effects of meatus and urinary catheter with 10% Povidone Iodine ointment on incidence of bacteriuria in hospitalized patients of neurological unit of Shohadaye Tajrish hospital in Iran. This study, is a randomized clinical trial which is done on seventy stroke patients that were catheterized by urologic experts selected on convenience sampling and randomly divided to two groups [Experimental group: 35 patients, Control group: 35 patients]. In the experimental group, meatus and catheter drainage tube junction were disinfected daily and spigot was disinfected two times a day by PVP10% ointment. In the control group the cares were done by normal saline. In days: 2, 5, 8, 11, 14 a urine sample was sent to lab for culture. The maximum period of study was 14 days. Incidence of bacteriuria in experimental and control groups were 20% and 42.9%, respectively. Relative risk was 2.14. In patients with positive urine cultures: puri was 85.7% in experimental group and 86.6% in control group. Clinical symptoms of UTI were seen in 28.6% in experimental group and 33.3% in control group. This study showed that application of povidone-iodine 10% ointment for disinfection meatus and catheter drainage tube junction is effective to prevent catheter-associated urinary tract infection in male patients

Determining the effect of touch on arterial blood oxygen saturation in neonates with respiratory distress syndrome

The use of complementary and alternative therapy is increasing and touch is one of them but several studies have indicated that premature neonates hospitalized in neonatal intensive care unit receive very little touch. The purpose of this research was to determine the effect of touch on arterial blood oxygen saturation in neonates with respiratory distress syndrome. This is a clinical trial with repeated measures that was performed on 37 neonates with respiratory distress syndrome. An information record form was used for data collection. The information record form was consisted of two parts: demographic information and a table for recording oxygen saturations. Oxygen saturation was measured by Nelkor pulse oxy meter. Information was collected in 3 sequential days. Arterial blood oxygen saturation was controlled 5 minutes before touch, then samples undergone 5 minutes touch and then in 5 and 15 minute intervals arterial blood oxygen saturation was controlled again. Data was analyzed using repeated measure ANOVA. Findings showed that in the first day, arterial blood oxygen saturation in 5 minutes before, and 5 and 15 minutes after touch were 95/67, 95/91, 96 respectively. In second day, arterial blood and oxygen saturation in 5 minutes before, and 5 and 15 minutes after touch were 95/72, 96/05, 96/08 respectively. In third day, arterial blood oxygen saturation in 5 minutes before, and 5 and 15 minutes after touch were 95/75, 96/16, 96/13 respectively. Arterial blood oxygen saturation in 5 and 15 minutes after touch were more than 5 minutes before touch in each 3 day [p<0.01]. But there was no significant difference between 5 and 15 minutes after touch. Data analysis also showed no significant difference comparing arterial blood oxygen saturation in the 3 days. Findings suggested that premature neonates physiologically responded to touch. Nurses working in NICUs must be educated about the importance of touch in providing care for these neonates. Findings showed that touch is useful for premature neonates and this fact can be a start point for other investigations