Developing patient safety standards for health-care quality promotion in neonatal intensive care units: A mixed-methods Protocol.

BACKGROUND: Neonatal intensive care unit (NICU) is one of the accident-prone settings in the health-care system. There is a series of structural and process threats to the safety of infants hospitalized in this unit, which can be prevented by taking the right actions. For this purpose, developing standards based on current knowledge, available resources, and the context that provides care can determine patient injury prevention requirements. Likewise, it can be a source for national development and application of related guidelines and protocols. This study aims to develop patient safety standards in the NICUs of Iran. MATERIALS AND METHODS: This mixed-methods study will apply the exploration, preparation, implementation, and sustainment framework to develop patient safety standards. In each phase of this framework, a set of activities take place. Exploration is based on the world health organization model to develop standards. Determining the validity and applicability of standards will be done in Phase 2 (Preparation) and Phase 3 (Implementation), respectively. Since the long-term effects are not desired, the fourth phase (Sustainment) will not be considered. DISCUSSION: Patient safety standards from this study will contribute to efficient and effective, equitable, and high-quality health-care delivery. The application of them will further promote patient safety and the quality of medical care in Iranian NICUs.

Effect of group hope therapy on self-efficacy of adolescents with type 1 diabetes.

OBJECTIVE: This study aims to determine the effect of group hope therapy on the self-efficacy of adolescents with type 1 diabetes. METHODS: This randomized clinical trial was conducted on 45 adolescent patients with type 1 diabetes in Iran. The subjects were randomly assigned into the intervention and control groups. The intervention group received eight 90-min sessions of group hope therapy using Snyder's method. RESULTS: The mean score of self-efficacies in the intervention group was significantly higher than the control group (p<0.05). CONCLUSION: The results of the study suggested that group hope therapy had a significant impact on self-efficacy of adolescents with type 1 diabetes but had no effect on academic self-efficacy and self-efficacy in blood glucose management.

Evaluating the implementation of helping babies survive program to improve newborn care conditiona.

BACKGROUND: The main reason of newborn mortalities in low- and middle-income countries is due to the lack of skilled caregivers in providing essential care for babies. The aim of the present study was to evaluate the implementation of helping babies survive (HBS) program to improve newborn care condition in Isfahan, Iran. MATERIALS AND METHODS: This quasi-experimental study was conducted in the labor and midwifery wards of Shahid Beheshti Hospital in Isfahan. Convenience sampling method was used for all healthy newborns who weighed >1500 g. First, the samples were selected for the control group. Then, the Helping Babies Breathe and Essential Care for Every Baby training courses were held over for ward nurses and midwives. Then, the samples of the intervention group were selected. The research tools consisted of demographic characteristic questionnaire, caregiver performance evaluation checklist, and breastfeeding registration checklist. SPSS software version 16 was used for data analysis. RESULTS: A total of 130 newborns were divided into control (n = 65) and intervention groups (n = 65). The average time of umbilical cord clamping increased from 13.85 to 61.48 s, and the average duration of skin-to-skin contact between mother and baby increased from 11.75 to 60.47 min. The mean of early initiation of breastfeeding improved during the 1st h and the 1st day of the birth. The rate of neonatal hypothermia in the intervention group decreased sharply. CONCLUSION: The implementation of the HBS program can positively impact newborn care condition.

Protective Dressings, Injury, and Device Failure in Preterm Infants Receiving Nasal Continuous Positive Airway Pressure: A Randomized Controlled Trial.

OBJECTIVE: To investigate the protective effect of a hydrocolloid nasal dressing on the incidence and severity of nasal injury and continuous positive airway pressure (CPAP) failure in preterm infants receiving nasal CPAP (N-CPAP). METHODS: A randomized controlled trial was conducted over 4 months in 2019 at level 3 neonatal ICUs in two hospitals affiliated with Isfahan University of Medical Sciences, Iran. Eighty eligible infants were born at 32 weeks of gestation or younger and/or with a birth weight of 1,500 g or less and had received between 4 and 72 hours of CPAP. Infants were randomly assigned to two groups; the intervention group used a protective dressing, and the control group received routine care. Data collection tools included a demographic questionnaire and nasal injury assessment score chart. MAIN OUTCOME MEASURES: The incidence and severity of nasal injury in preterm infants undergoing N-CPAP. RESULTS: Infants in the intervention group had a significantly lower incidence and severity of nasal injury compared with the control group: 15 of 40 (37.5%) versus 37 of 40 (92.5%; P < .001). Overall, the injuries identified in this study were mostly mild and moderate, with only three severe injuries in the intervention group and five in the control group. No significant differences were detected in CPAP failure (P > .05). CONCLUSIONS: The studied nasal barrier dressing is a safe and convenient solution to reduce nasal injury in preterm infants receiving N-CPAP.

Evaluation of in-person continuing education programs from the perspective of ward nurses.

BACKGROUND: Assessing how programs are implemented from the perspective of the learners themselves is one of the most effective ways to improve the quality of continuing education. The aim was to evaluate the implementation of in-person continuing education programs from the perspective of nurses. METHODOLOGY: Setting of the study was the selected hospital of Isfahan University of Medical Sciences (Al-zahra hospital). This study is a descriptive cross-sectional one. Using a researcher-made questionnaire, the implementation of continuing education programs in four areas of the aim, educational techniques, educational content, and educational field was evaluated. The sample consisted of 236 nurses working in these hospitals who participated in the study through convenience sampling. Data were analyzed by SPSS software version 19 using descriptive statistics. RESULTS: Based on the results, "the need for new content learning" was mentioned as the first priority in continuing education programs. The majority of participants scored each of the following domains (aim, educational techniques, educational content, and education field) as well as all items related to the continuing education program evaluation as "moderate." CONCLUSION: Most nurses assessed the implementation of in-person continuing education programs implemented in Isfahan University of Medical Sciences in general and in each of the domains as "moderate." Therefore, in order to improve the quality of programs, it is necessary to take steps to match the goals with the needs of learners, improve teaching techniques, improve the quality of program contents, and optimize the scope of the programs.

Clinical Guideline for Nursing Care of Children with Head Trauma (HT): Study Protocol for a Sequential Exploratory Mixed-Method Study.

BACKGROUND: Head trauma is a major health problem. Its primary complications happen at the time of trauma and are inevitable; thus, head trauma management is focused on the prevention and management of secondary complications. A clear clinical guideline for head trauma care can help nurses effectively prevent and manage secondary complications. This study aims to develop the clinical guideline for nursing care of children under 18 years with head trauma hospitalized in emergency departments, critical care units, and neurosurgery wards. METHODS: This sequential exploratory mixed-method study will be conducted in three main phases as follows: qualitative, systematic review, and integration phases. In the qualitative phase, semi-structured interviews will be conducted to determine the care-related needs of children with head trauma. In the systematic review phase, a systematic review will be performed to find and then to review the most relevant articles, books, and the appropriate clinical guidelines. The quality of the retrieved guidelines will be assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. In the integration phase, the findings of the qualitative and systematic review phases were integrated, the draft of the guideline will be prepared, which will then be revised and validated through a nationwide Delphi survey. DISCUSSION: The guideline for nursing care of children with head trauma can help to more effectively prevent, reduce, and manage the secondary complications of head trauma. Moreover, it reduces disability and mortality rates, improves nursing care quality, decreases healthcare costs, shortens hospital stay, and makes more rational clinical decisions.

The Effect of Foot Massage by Mother on the Severity of Attention-Deficit Hyperactivity Disorder Symptoms in Children Aged 6-12.

BACKGROUND: Various pharmacological and non-pharmacological approaches have been proposed to control the symptoms of Attention-Deficit Hyperactivity Disorder (ADHD). The aim of this study was to investigate the effect of foot massage by a mother on the severity of ADHD symptoms in children. MATERIALS AND METHODS: This study was a randomized controlled trial conducted on 56 children who referred to psychiatric clinics affiliated to Isfahan University of Medical Sciences in Iran, 2018. The subjects were randomly divided into two groups of intervention and control. In the intervention group, after giving massage therapy training to the mother, the mother massaged her child's foot three times a week for 1 month. The data were collected using the ADHD questionnaire. Data were analyzed using inferential and descriptive statistics (independent t-test, paired t-test, Mann-Whitney test, and Chi-square test). RESULTS: Comparison of the mean score of ADHD symptoms, after the intervention, showed a significant difference between the two groups in terms of the dimensions of the memory and attention deficit (t47 = 3.42, p = 0.001), lack of responsibility and organization (t47 = 7.16, p < 0.001), lack of cooperation with others (t47= 5.23, p < 0.001), and the total score of symptom severity (t47 = 3.78, p < 0.001). CONCLUSIONS: Massage therapy is affordable and low-cost care that together with pharmacotherapy programs can reduce some symptoms of ADHD.

The Effect of Intelligence Self-Control Program on the Quality of Life of the Adolescents with Type I Diabetes.

BACKGROUND: Diabetes affects patients' quality of life in almost all physical, mental, and social areas. The aim of the present study was to determine the effect of self-control intelligence program on the dimensions of quality of life in the adolescents with diabetes. MATERIALS AND METHODS: The present study is a randomized controlled trial with pre-test and post-test design in which 56 adolescents with diabetes referring to the Janan charity diabetic association in Najafabad in 2018 (Isfahan, Iran) were selected by convenience sampling method and were randomly divided into two groups of intervention (n = 28) and control (n = 28). Self-control intelligence program was performed for the intervention group. The data were collected using standard Quality of Life Questionnaire for adolescents with diabetes and were analyzed using Chi-square test, independent and dependent t-test, Mann-Whitney. RESULTS: Statistical tests showed no significant difference between the groups in terms of their demographic characteristics such as gender, duration of diabetes, and the number of insulin injections. There was, however, a significant difference in the mean scores of all quality of life dimensions except for the dimension of physical symptoms both before and after the intervention in the intervention group (t23 = 4.46, p < 0.001). By contrast, no significant difference was observed in the mean scores of quality of life before and after the intervention in the control group (t24 = 0.08, p = 0.93). CONCLUSIONS: Based on the results, self-control program can have an effective role in the adoption of coping strategies and, thus, improves the patients' quality of life.

Laying the Foundations of Lifelong Health at the Beginning of Life: Islamic Perspective.

In this systematic literature review, all the Shiite-Islamic documents (Quran and Hadith) without any time limitation were surveyed, analyzed and synthesized for the purpose of determining the foundations of lifelong health. The data were analyzed and combined using inductive qualitative content analysis method. Two main categories were emerged from the analysis: "prevention of health problems" and "health maintenance and promotion." In conclusion based on Islamic perspective, the foundations of comprehensive health of a person, i.e., health in all physical, mental, social, and spiritual dimensions, are begun to form at four stages: the time of marriage of his parents, the moment of their conception, when he is unborn in his mother womb, and during infancy period. Observing religion instructions in this regard is not the sufficient condition for being completely healthy; however, such instructions can provide a base for being a healthy person.

An inquiry into the concept of infancy care based on the perspective of Islam.

All schools of thought believe that infancy is crucial to the formation and development of the human character. Nevertheless, a search of literature revealed the lack of a clear definition of the concept of 'infancy care based on an Islamic perspective' in nursing texts. As the lack of a clear definition of a concept conveys the inapplicability of that concept to its relevant field and community, this study was conducted to explore and determine the characteristic features of the concept of infancy care based on the perspective of Islam. Walker and Avant's (Strategies for theory construction in nursing. Prentice Hall, Boston, 2011) literary concept synthesis as the manner of concept development approach was conducted. Islamic documents were surveyed without any time limitation. Findings involved the extraction of six main concepts, including God as the Merciful Nurturer, mother as the symbol of the Creativity and Divinity of God, infant as a person with dignity and potential for excellence, parents as the nurture way paver, basic principles of nurturing, and holistic lifelong health promotion. The theoretical definition of each concept was presented. From the perspective of Islam, infant care is the nurturing of a human who has been conceived with dignity, certain rights, identity, and the capacity for development and excellence.