ABSTRACT
Despite many progresses in the improvement of care status and the management of acute coronary syndrome, cares quality is far from the desirable conditions. Today, due to the great emphasis on resources management, costs control, the effectiveness of patient care, improving quality and responsibility, the good patient care is necessary. Two dimensions are referred for improving the quality: process [standard- based and safe services] and resultant [client satisfaction]. The present study, aimed at determining the impact of Synergy Model on nurses' performance and the satisfaction of the patients with acute coronary syndrome. In a quasi- experimental study in a two-group and two-step form, a sample of 22 nurses and 64 patients with acute coronary syndrome in cardiac intensive care units of some university hospitals in 2010-2011 were recruited. Synergy Model was explained and carried out for the studied groups in a workshop and its impact on nurses performance in different areas and patients' satisfaction was examined by using two checklists: "examining the nurses' performance quality" and "examining the patients satisfaction". Differences between the mean scores of the nurses in communicative, supportive, care and educational domains and total performance were statistically significant before and after the intervention [p < 0.001]. However, in therapeutic domain, changes were not significant. There was a statistically significant difference between the average satisfaction score of the two groups [p < 0.001]. Applying Synergy Model as a basis for receiving nursing cares was effective in increasing patient satisfaction and in the performance of nurses of cardiac intensive care units.
ABSTRACT
Each group or profession has its own discourse. Discourses create identity, support institutions and reproduce power relationships. Professional identity of Iranian nurses, which has recently had the opportunity to represent itself in social arena, needs investigation. This study aimed to make internal aspect of this identity clear. This study was conducted by discourse analysis, using data of 23 semi-structured individual interviews and 4 focus group interviews with nurses and senior nursing students of Tehran and Isfahan University of Medical Sciences, Iran, to evaluate their professional identity. In professional self-concept, elements like spirituality value and low financial benefits were identified as well as conflicting features of holiness and humility, identity emerging, identity escape, low professional self-confidence and justice seeking, lost professional authority and pride. Nursing professional identity has been formed based on cultural social structure, values and beliefs governing health system. This is a spectrum of a growing and emerging identity to a developed but forgotten identity. Although nursing discourse is subordinate in health system discourse, signs of moving toward professional maturity have emerged.
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.