Effect of clinically competent nurses services on safety and patients5 satisfaction in an emergency department

Access to quality care is important in delivering health services. Patients' safety and satisfaction are indicators of quality of care evaluation. Competent nurses may deliver quality care. This study aimed to investigate the impact of using competent nurses on patients' safety and satisfaction. In this interventional study with non-equivalent control group, we selected 120 patients admitted to the emergency department of Imam Khomeini hospital in 2012 using convenience sampling method. Nursing care for the experimental group [n=40] was provided by nurses who had high competency scores and. In the control group [n=80], nursing care was provided by usual emergency department nurses. Data were collected using the patient satisfaction with nursing care quality [PSNCQ], and patient safety inventory. Data were analyzed in the SPSS v.l 6 using descriptive and inferential statistics. The significance level for all statistical tests was considered at P0.05. Mean age of the intervention and control groups were 48.1 [ +/- 12.5] and 40.5 [ +/- 16.7], respectively [P0.018]. There was a significant difference between the two groups in terms of employment [P0.009]. The two groups were similar in terms of other variables such as gender, marital status, level of education, having health insurance, and the reasons for seeking admission. The results showed that there were significant differences between the two groups in patients' safety and satisfaction with nursing care [P0.001]. Regression test was used to eliminate the effects of age and job satisfaction; the results showed effect of intervention on the patients' safety and satisfaction with nursing care. These findings indicated that using competent nurses in providing nursing care promotes patients' safety and satisfaction with nursing care. Training nurses focusing on the level of competency is required in scheduling, staffing, and implementing nursing care to enhance safety, patient satisfaction, and quality of care

[Adherence of family caregivers of patients with stroke to rehabilitation regimen]

Due to physical and mental complications, stroke causes disability in self-care and adherence to rehabilitation in patients. The purpose of this study was to assess the adherence to rehabilitation regimen in family caregivers of patients with stroke. In this cross-sectional study, 180 family caregivers of patients with stroke were recruited to the study using convenience sampling method. The participants were asked to complete demographic sheet and the Adherence-of-Therapeutic-Regime Questionnaires during two months of stroke. Data were statistically analyzed using descriptive and inferential tests in the SPSS-16. Findings indicated that only about 10% of caregivers were in good levels of adherence to the rehabilitation regimen; and about 25% of them were weak. The weaknesses of the adherence were related to rehabilitation of motion, cognitive and emotional deficiencies, and also prevention of respiratory and skin disorders. According to the study, a small number of family caregivers were in appropriate level for adherence to the rehabilitation regimen. The nurses should be able to empower the family caregivers to decrease physical and psychological disorders related to stroke in patients

[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

[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

[Effect of matrica mouth wash on prevention of head and neck radiotherapy induced-stomatitis]

Oral care and using mouthwash help to prevent stomatitis. The aim of this study was to investigate the effect of two mouth wash protocols on prevention of head and neck radiotherapy induced-stomatitis. In this single blind clinical trial, 120 individual were recruited. The experiment group [N=40] gurgled with 3cc of Matrices mouthwash and the control group used water mouth wash. The participants were assessed using the WHO grading scale. Data were analyzed using the Fisher exact test and Mann-Whitney U test as appropriate. There was not significant differences between the experimental and control groups regarding stomatitis intensity in the first day [P=0.371]. There were significant differences between the two groups regarding stomatitis intensity in days 7 and 14 [P<0.001]. Oral stomatitis is a common condition in patients with head and neck radiotherapy. It makes painful ulcers, dehydration, malnutrition, and potentially life-threatening infection. Matrica mouth wash could prevent and treat induced-radiotherapy ulcer stomatitis