The comparison between the impacts of henna and nail polish on pulse oximetry among healthy women

Pulse oximetry is a frequently used and standard non-invasive method for monitoring oxygen [O[2]]-saturation in blood. Many factors including dark skin and pigmentation may effect on rate of saturation of the blood oxygen absorbed by pulse oximetry. The effect of nail polish and/or henna color on blood oxygen has not been yet identified and the present study has been carried out by aiming at the review on impact of henna and nail polish on results of pulse oximetry. In the current investigation, clinical trial was studied on 60 resident young women at ages 20-40 by means of purposeful sampling method. Initially, 20 g of Iranian original henna was solved in 30 ml water and put on forefinger of non-dominant hand of the subjects. The other fingers of the same hand were stained by red, black, and white nail polish, respectively. The middle finger of the same hand was considered as the control variable. Then, blood O[2]-saturation was measured by two calibrated pulse oximetry devices simultaneously. The results indicated that henna [P = 0.020], red nail polish [P

Effects of active and passive implementation of ventilator associated pneumonia guideline on nurses' performance in critical care units: a controlled clinical trial

Ventilator associated pneumonia [VAP] is the most common infections in critical care units, which leads to more length of hospital stay, costs, and high mortality. Therefore, prevention is a priority according to clinical guidelines. The aim of this study is determine the effects of passive versus active implementation of VAP guidelines on nurses' performance in critical care units. In this controlled clinical trial, 110 nurses who working in critical care units in selected hospitals affiliated to Tehran University of Medical Sciences were enrolled to study by convenience sampling at three groups, including active intervention group [n = 40], passive intervention [n = 36], and control [n = 34]. First, nurses' performance in prevention of VAP was evaluated by an observational checklist. In passive intervention group, posters containing recommendations of prevention of VAP was installed over the wall for each bed. In active intervention group, in addition to poster installation, there were training sessions with feedback on nurses' performance. In control group without any intervention, just nurses' preventative performance was evaluated before and 1 month later. A month later the nurses' performance were observed. Data were analyzed by descriptive and inferential tests [Fisher's exact test, chi-square, ANOVA, and paired t-test] in SPSS version 16. Results showed that the nurses' mean percentage score in three groups was 46.80 +/- 5.79 and after intervention it changed from 47.76 +/- 4.61 to 63.32 +/- 6.97 [P < 0.001] in active group, from 45.24 +/- 5.72 to 55.03 +/- 10.20 [P < 0.001] in passive group and 47.33 +/- 6.86 to 47.90 +/- 6.06 in control group [P = 0.263]. Nurses' performance in active group improved significantly in comparison to passive group and in passive group, it improved significantly in comparison to control group [P < 0.001]. The results of this study showed that both active and passive methods are effective on nurses' performance in prevention of VAP. Therefore, considering the existing situation in the country and the high workload of nurses, we can offer VAP guideline as a protocol in critical care units

[Nurses performance in prevention of ventilator associated pneumonia]

The ventilator associated pneumonia is a common problem in critical care units. It is associated with increased mortality, cost and length of stay. Nurses have great role in preventing the ventilator associated pneumonia. The aim of this study was to assess nurses' performance in prevention of ventilator associated pneumonia. In this descriptive study, 110 nurses working in selected hospitals affiliated to Tehran University of Medical Sciences were selected using convenience sampling method. A 32-item observational checklist was provided based on the ventilator associated pneumonia prevention guideline. The nurses' performance was observed three times. Data were analyzed using descriptive statistics in the SPSS-16. This study showed that the mean score of the nurses' prevention was 46.8 +/- 5.79. Most of the nurses [66.4%] had poor performance; and 36.6% had relatively good performance. There were no nurses with favorable performance in the prevention of ventilator associated pneumonia. The highest score was in contact precaution [72 +/- 9.67] and the lowest score was in mouth hygiene [18.78 +/- 17.4]. The majority of nurses had poor performance in prevention of ventilator associated pneumonia. More attention should be paid for planning appropriate training programs for nurses and giving adequate facilities to improve health care quality

[Effectiveness of a multifactor educational intervention on delirium incidence and length of stay in patients with cardiac surgery]

Delirium is a common problem among patients with open heart surgery admitted to intensive care units. This study aimed to assess effectiveness of a multifactor intervention on delirium prevention and length of stay in patients with open heart surgery. In this semi-experimental study, we first recruited 195 patients. Among them, 15 patients were excluded during the study due to different reasons. The participants were divided into to study groups. The implemented intervention included staff education, environment changes, and installation of guideline reminding on ward. Patients were assessed for delirium twice a day using the CAM-ICU scale. Demographic characteristics as well as disease and sleep items were completed by the researchers a day before surgery. Moreover, length of stay was recorded by the researchers. Data were analyzed using Pearson Chi-Square, Independent Samples, and the Fisher's Exact Test. A significant decrease was found in the incidence of delirium in the intervention group: 11.1% Vs 35.6% [P<0.05]. Average length of stay in the control and intervention groups was 6.23 Vs 6.30 days, respectively. Length of stay among patients with delirium and patients without delirium was 7.5 Vs 5.8 days, respectively. Patients with delirium were aged 55 and more in both groups. Multifactor intervention was effective in decreasing the prevalence of delirium. Educational interventions are recommended to improve staffs' knowledge and environment changes

[Effect of application of critical-care pain observation tool in patients with decreased level of consciousness on performance of nurses in documentation and reassessment of pain]

The presence of pain is a common phenomenon among patients in critical care units. Critically ill patients are often unable to communicate because of illness or sedation; so, recognition and assessment of their pain is difficult. In these patients, observational behavioral indices can be used to evaluate pain. The aim of this study was to investigate the effect of application of critical-care pain observation tool in patients with decreased level of consciousness on performance of nurses in documentation and reassessment of pain after palliative intervention. In this before and after quasi-experimental study, 106 nurses working in general intensive care units in selected hospitals affiliated to Tehran University of Medical Sciences were selected. First, we examined the nurses' performance three times in relation to documentation and reassessment of pain after palliative intervention, position change and suction procedure in patients with decreased level of consciousness using a researcher-made check list. Then, we taught nurses individually, how to use this tool to investigate the pain of patient in a session lasting an hour. A week after the training, the researcher reevaluated performance of trained nurses in relation to documentation and reassessment of pain after palliative intervention in patients with decreased level of consciousness. Finally, those data collected before and after the training of the CPOT to nurses were compared using the Wilcoxon test. Findings showed that the CPOT could not lead to improved nurses' function in relation to documentation of pain in the patients records [P=0.209] and recording palliative measures related to pain [P=0.117]. However, there were significant statistical differences between nurses' function in relation to reassessment of pain after palliative intervention, before and after the training and application of the CPOT. Comparing the mean function scores before and after the intervention, demonstrated that the performance of nurses in this area has been improved after the intervention. The critical-care pain observation tool can increase nurses' sensitivity to pain in patients with decreased level of consciousness. It forces the nurses to reassess the pain after palliative intervention. This tool does not motivate in nurses to document pain palliative process. So it is recommended that future studies investigate the impact of this tool on other aspects of pain management, such as diagnosis of pain and using of drugs and non-drug measures

[Education of how-to-use peak flow meter and following up via SMS on asthma self-management]

Asthma is one of the most prevalent chronic diseases worldwide. About 6.5 million people suffer from asthma in Iran. The Effective strategy to control asthma is related to education. The self-management has a major role in the standard education program. This study aimed to assess the effect of education on using peak flow meter and follow up via SMS on asthma self management. This study was a quasi-experimental controlled clinical trial. The samples included 98 patients, suffering from asthma referred to the pulmonary clinic in Imam Khomeini and Shariati hospitals. Patients were selected using convenient sampling method and were randomly assigned into the experiment [n=47] and control [n=51] groups through blocking method. Two educational sessions were held in the experiment group about how-to-use peak flow meter. Accordingly, the patients in the experiment group sent their peak flow rates via SMS to the researcher within 12 weeks. The researchers provided feedback to the patients about their asthma control via phone, weekly. Patients in the control group did not receive any education. Data were collected using the Asthma Control Test before and three months after the intervention. Data were analyzed using the statistical tests of Chi-square, Mann-Whitney, Independent t-test and Kolmogorov-Smirnov. There was a significant statistical difference between the two groups of experiment and control in terms of asthma control [P=0.002]. The education using peak flow meter and following up via SMS promotes asthma self-management. With regard to the significant role of nurses in patient education, educating patients with asthma by nurses is recommended at the Iranian Society of Asthma and Allergies clinics and medical centers

[Modification of environmental factors on quality of sleep among patients admitted to CCU]

Poor sleep quality is a common problem among patients hospitalized in the CCUs. This study aimed to determine the effect of environmental factors modification strategies on quality of sleep among patients admitted to CCU. This was a quasi-experimental study with a single-blinded design. Sixty patients admitted to the CCU of Shariati hospital were divided into two experiment and control groups. Sleep quality was measured in the first day of admission and three days later using the Pittsburgh sleep quality index in both groups. In the intervention group, we implemented a modified work environment between the two measurements. Data were analyzed using the Chi squared and t-test in the SPSS v.18. Findings showed a significant decrease in sleep quality in the control group after hospitalization, compared with the intervention group [P<0.001]. There were no statistically significant changes in the sleep quality before and after hospitalization in the intervention group [P=0.053]. Using environmental factors mitigation strategies can improve sleep quality of patients admitted to CCUs

educational intervention using health belief model on smoking preventive behavior among female teenagers

Cigarette smoking is a common risky behavior among teenagers. Theories and models of health education aim to design effective educational programs. This study has been conducted to assess the effect of a health education program designed based on the health belief model on preventive smoking behaviors among female teenagers. In this quasi-experimental study, 176 female teenagers from the Educational Cultural Centers of 17 zones of Tehran Municipality were randomly allocated to two equal experiment and control groups [88 girls in each group]. The designed educational program was presented to the experiment group through three lecture and question/answer 45 minute sessions. Data were collected using a questionnaire before and eight weeks after the intervention. Data were analyzed using the SPSS-16. There was no significant difference between the two groups in the characteristics of the participants before the intervention. Comparison of the two experiment and control groups after education showed that the mean score of all studied constructs of the health belief model [i.e., susceptibility, severity, benefits and barriers, cues to action], as well as the preventive behaviors were increased significantly. The results of this study showed that the program seems to be helpful in promoting the smoking preventive behavior among teenagers

Learning outcome in two different teaching approach in nursing education in Iran: E-learning versus lecture

Traditional teaching methods used in medical education couldn't meet the need for keeping pace with up to date information. Present study has conducted in order to compare the effect of lecture and e-learning methods on nursing students' learning outcomes in the context of Iran. A cross-over design was applied. Study sample was consisted of 32 students which were in third semester of nursing bachelor program and were passing Maternal Child nursing course. The first part of the course was taught using lecture method during first four weeks; an e-learning method was the technique used to educate the remained part of the course during the second four weeks. Students' learning outcomes in each method, opinion toward and participation with both educational methods was assessed. No significant difference was found between students exam scores in both methods. Considering students' opinion toward educational methods, no significant difference was found between two methods in general but students reported better "capability" and "independency" in e-learning method while lecture was obtained higher scores in "effectiveness on learning" and "motivation" characteristics. E-learning can be used in teaching some nursing courses. It is recommended to use e-learning method with appropriate interactive strategies and attractive virtual environments to motivate students

Mobile phone text messaging and telephone follow-up in Iranian type 2 diabetic patients for 3 months: a comparative study

This study was performed to compare the effectiveness of two methods of follow-up: Short Message Service [SMS] versus telephone call on glycosylated hemoglobin [HbA1c] in type 2 diabetes. This semi-experimental study consisted of 77 patients with type 2 diabetes who were randomly assigned into two groups: telephone follow-up [n=39] and Short Message Service [n=38]. Telephone interventions were applied by researchers for 3 months. SMS group received message daily for 12 weeks. Data were collected using data sheet to record HbA1c and a questionnaire consisted of demographic characteristics. Data were analyzed by SPSS 11.5 using descriptive and inferential statistics methods. Demographic variables were confirmed to be homogenous. The results of this study showed that both interventions had significant mean changes in HbA1c; for the telephone group [P=0.001] with a mean change of -0.93% and for the SMS group [P=0.001] with a mean change of -1.01%. The findings of this research showed that intervention using SMS via mobile phone and nurse-led-telephone follow-up improves HbA1c for three months in type 2 diabetic patients and it can be considered as an alternative method for diabetes control