Electrolyte Imbalance Among Patients With and With No ST-Elevation Myocardial Infarction: A Cohort Study.

Electrolytes imbalances are highly prevalent and have shown a high impact on mortality in patients with acute myocardial infarction. These electrolytes imbalance have prognostic value in predicting mortality in patients with acute myocardial infarction. The purpose of this study was to assess the prognostic value of electrolyte imbalances in predicting 1-month mortality among patients with myocardial infarction with and with no ST-elevation. This cohort study was conducted in a referral hospital in the West Bank, Palestine. All patients with confirmed medical diagnosis of acute myocardial infarction and admitted to the medical coronary care unit in the hospital were eligible participants. A convenience sample of 186 participants was obtained. These participants were followed up for 1 month to assess their survival (alive or dead). Demographic and clinical data were recorded by reviewing their health records. The derived data were analyzed using SPSS version 19. About 36% of all patients were found to be hyponatremic, 15% of them have hypokalemia, and 9% of patients had hypocalcemia. There was a significant difference between STEMI and non-STEMI in sodium (t = 4.7, P < .001). A multivariate logistic regression analysis was performed to predict 1-month mortality for patients with myocardial infarction with and with no ST-elevation. The predictors that were found to be significant are sodium (odds ratio [OR] = 0.789, P = .010), calcium (OR = 0.221, P = .014), diastolic blood pressure (OR = 0.933, P = .047), and blood urea nitrogen (OR = 0.821, P = .005). Electrolyte imbalance was highly prevalent among patients with acute myocardial infarction. Hyponatremia and hypocalcemia were present and associated significantly with predicting 1-month mortality. Health care providers should take into consideration the electrolytes of patients with acute myocardial infarction from the first moment of admission and correct them early to maximize the clinical outcomes and survival for patients.

Challenges to online education during the time of COVID-19: A focus group study.

AIM: To explore the experience of online education during coronavirus disease 2019 (COVID-19) from the perspectives of nurse educators, postgraduate students, and undergraduate students in two universities in the Occupied Palestinian Territory (OPT). This article only highlights the challenges faced by nurse educators and students. METHOD: A qualitative design using a focus group strategy was employed. The data were collected from two universities in the OPT from September 2020 to October 2020. The maximum variation sampling strategy was used. FINDINGS: Seven focus groups were conducted with nurse educators (n = 2), postgraduate students (n = 1), and undergraduate students (n = 4). The findings revealed that nurse educators and students faced several challenges when they were abruptly turned to online learning. These challenges included challenges concerning clinical courses, lack of resources, lack of interaction, evaluation, and their home environment. CONCLUSIONS: This study is the first to demonstrate the challenges involved in nursing education in OPT during the COVID-19 pandemic. IMPACT: The findings of this study can be used to improve the online learning experience during COVID-19. As a recent change to nursing education, it is vital to understand the nature of the problems related to this sudden change.

Awareness of Delirium by ICU Nurses.

Delirium is a critical issue in the intensive care unit (ICU), and the correct diagnosis and treatment of this disorder by the ICU team are doubtful on many occasions due to a lack of information. This research is intended to test the awareness and control of ICU delirium by the ICU nurses. A nonexperimental, quantitative, descriptive, cross-sectional study was conducted using a previously adopted and translated to Arabic and validated questionnaire. The sample include nurses who work in ICUs of 10 Palestinian hospitals (private and public) located in the West Bank and Jerusalem participated in this study; each gave consent to be part of this study. Approval was received from the Palestinian Ministry of Health and the Ethical Committee at Birzeit University. Version 19 of the Social Sciences Statistical Package (SPSS) software was used to analyze the data. The results showed that ICU nurses hold moderate to low levels of knowledge and lack of adequate clinical experience to handle delirium. Delirium is a common complication in the ICU that increases morbidity and mortality and increases the length of ICU stay, therefore the cost of health care rise and the quality of life is decreased. In clinical practice, there are no assessment guidelines and protocols for patients with delirium.