Medical-Surgical Nursing Journal
Year:2019 | Volume:8 | Issue:1|Papers Count:7

Background: One of the most fundamental causes of medical errors is the lack of proper communication between the members of the treatment team. The World Health Organization (WHO) has introduced the surgical safety checklist (SSC) for surgical safety to provide a safe environment for patients undergoing surgery, improve communication between surgical team members, and prevent potential medical errors. Objectives: This study evaluated the communication patterns of surgical teams in order to examine the ways to implement various guidelines of the SSC. Methods: In this descriptive cross-sectional study, a trained researcher attended 48 operations from late September to late November 2018. The observer recorded qualitatively the communication behaviors of the surgical team in implementing various items of the SSC. The observations were subsequently examined in two general categories of verbal and non-verbal communications. The surgical procedures were observed at three stages: patient’ s admission until entry to the operating room, entry to the operating room until anesthesia induction, and anesthesia induction until patient’ s transfer from the operating room. Results: In this study, 31 individuals took part in 48 diff erent surgical teams. Observing the communication patterns revealed the lower frequency of verbal communication (13. 27%) than that of non-verbal communication (32. 12%). The most frequent failure in verbal communication occurred at the anesthesia induction stage (48. 57%) and it was related to operating room equipment (6 out of 35 cases of failure). By contrast, the least frequent failure in verbal communication was associated with patient’ s admission until entry to the operating room (17. 14%). Conclusions: Various cases of communication failure were seen among surgical team members. It is proposed that appropriate training programs be devised to establish a successful communication environment for the correct use of SSC and further clarifi cation of communication patterns in surgical procedures.

Background: Promoting adherence to self-care behaviors is crucial in people with heart failure (HF) who also suff er from psychological problems like depression. The purpose of this study was to disclose the eff ect of cognitive-behavioral education, compared to conventional training, on self-care behaviors in depressed HF patients. Methods: This randomized clinical trial was performed on 80 individuals (40 in the behavioral-cognitive education group and 40 in the conventional education group) with heart failure and depression who had been admitted to the Cardiology Ward of Ali-ibnAbitaleb and Khatam-al-Anbiya hospitals of Zahedan in 2018. Data were collected using the Beck depression inventory (BDI) and the self-care heart failure index version 6. 2 (SCHFI V. 6. 2) before and eight weeks after the end of educational interventions. Patients in the control group received the routine educational materials in four sessions, whereas those in the treatment group received the related educational content through cognitive-behavioral therapy technique in fi ve sessions. Data were analyzed in SPSS V. 21 using independent and paired t-tests, chi-square, and covariance analysis. Results: Although the mean score of self-care behaviors in the cognitive-behavioral group and the conventional education group was not signifi cantly diff erent before the intervention, it was signifi cantly higher in the treatment group (65. 14  7. 01) than in the control group (36. 59  8. 25) after the intervention. Conclusions: Given the dramatic impact of cognitive-behavioral education on the improvement of self-care behaviors, it is suggested that the principles of this therapy be integrated into common educational programs for depressed patients with heart failure.

Background: Improving the self-effi cacy of cardiac patients is one of the pressing necessities that must be considered in the healthcare system. Meeting this urgent need requires comprehensive educational programs. Objectives: Therefore, the present study aimed at exploring the impact of empowerment on the self-effi cacy of patients with ischemic heart disease who had been hospitalized in Imam Khomeini Hospital affi liated to Lorestan University of Medical Sciences. Methods: This clinical trial was carried out in 2018 on patients with ischemic heart disease who had referred to Imam Khomeini Hospital in Pol-e Dokhtar, Lorestan province, Iran. A total of 56 patients were randomly chosen and assigned to the control and experimental groups. The standard chronic disease self-effi cacy scale (CDSES) was used for data collection. The empowerment program was presented in three 45-minute sessions, and the data were analyzed by SPSS version 23 using covariance, independent t test, and descriptive statistical tests. Results: The results of the independent t test revealed no signifi cant diff erence in the mean scores of self-effi cacy between the two groups before the intervention. However, after the intervention and at the fi rst and second phases of control, the mean score of selfeffi cacy was higher in the experimental group than in the control group. Moreover, the results of covariance analysis established that while self-effi cacy promoted in the experimental group, it did not change in the control group. Conclusions: Empowerment training can promote self-effi cacy in patients with ischemic heart disease, which, in turn, can facilitate their treatment process and ultimately enhance the health system effi cacy.

Background: The long-term complications of hemodialysis deteriorate patients’ quality of life and lead to physical and mental discomfort. Physiologically, sports activities can play an important role in reducing these side effects including muscle cramps. Objectives: The aim of this study was, to determine the impact of isotonic exercise on the frequency of muscle cramps. Methods: This clinical trial was carried out on 60 hemodialysis patients admitted to the dialysis units of Shahrekord and Borujen hospitals in 2014. The intervention included an isotonic exercise program that was implemented during 10 sessions of constant cycling (each lasting 10 minutes) immediately before dialysis. The outcome variable was the number of muscle cramps in patients during the hemodialysis session. The data were analyzed in SPSS-16 using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential tests (independent and paired t-tests). Results: The mean frequency of leg cramps before the intervention was not significantly different between the two groups (P = 0. 10). However, it was significantly different between the groups after the intervention (P = 0. 001). Moreover, the number of muscle cramps in the experimental group was significantly lower after the intervention than before implementing the program (P = 0. 03). Conclusions: The isotonic exercise of constant cycling has a considerable effect on decreasing the number of muscle cramps in hemodialysis patients. Hence, it is suggested that dialysis units provide facilities for constant walking and cycling to accelerate patients’ treatment.

Background: Given that diabetes is the most prevalent cause of end-stage renal disease (ESRD) and that dialysis adequacy is an important factor in the survival of diabetic patients, prognosis of these individuals is predicated according to adequate and standard hemodialysis. Objectives: The present study aimed at investigating the eff ect of lowering dialysate solution temperature on dialysis adequacy. Methods: This was a clinical trial, in which 32 qualifi ed patients were studied. The subjects were chosen by convenience sampling from patients, who had referred to Ali-Ibn Abitaleb Hospital of Zahedan in spring, 2018. Each patient underwent hemodialysis twice, in which the solution temperature was reduced by one temperature from 37° C to 36° C. Except for the temperature decrease, other conditions were identical during the study. To evaluate the adequacy of dialysis in each session, blood samples of patients were examined before and after dialysis. Data were analyzed in SPSS 21 using descriptive statistics and dependent t-test. The signifi cance level was set below 0. 05. Results: The mean and standard deviation of age was equal to 60. 2  9. 2 (year), duration of diabetes was 12. 07  7. 25 years, duration of hemodialysis was 27. 7  21. 8 (months), and weight gain between two sessions of dialysis was 1. 6  0. 68 (kg). The mean and standard deviation of dialysis adequacy index equaled 1. 14  0. 34 in the two cold sessions and 0. 98  0. 20 in the routine session, suggesting signifi cantly higher value in the cold sessions (P < 0. 001). Conclusions: Administering cold dialysis solution (36° C) positively infl uences dialysis adequacy. Therefore, if patients are not medically prohibited from using the cold solution, cold dialysis solution should be prescribed to hemodialysis patients.

Background: One of the non-pharmacological methods for relieving pain in children is to deploy cognitive-behavioral interventions such as distraction therapy. Objectives: The aim of the present study was to examine the impact of distraction on physiological indices and the severity of pain caused by intra-spinal injection of chemotherapy drugs in children with cancer. Methods: This was a clinical trial with a pretest-posttest design. The subjects included 89 cancerous children aged 6-12 years who had been admitted to the HematologyWard of Ali Ibn Abitalib Hospital, Zahedan, Iran. The patients were divided into the intervention (n = 45) and control (n = 44) groups. In order to distract the children, they were asked to choose one out of three animated series based on their interest. They received the injection while watching the cartoon. Then, the severity of pain caused by intra-spinal injection of the chemotherapy medication, heart rate, and arterial oxygen saturation (SaO2) were evaluated. Results: Arterial oxygen saturation of the intervention group increased from 95. 42 4. 53 before distraction to 98. 04 2. 20 after distraction (P < 0. 001). The mean heart rate in the intervention group decreased from 108. 64  13. 36 before distraction to 104. 00  12. 25 after distraction, suggesting a significant difference between the two groups (P = 0. 04). The mean changes in the heart rate were significantly differentbetween thetwogroups (P< 0. 001). Moreover, themeanpain intensity after distractionwassignificantly lower in the intervention group (35. 11 14. 71) than in the control group (42. 5 16. 44) (P = 0. 02). Conclusions: Based on the results, distraction therapy can be effective in mitigating the severity of pain caused by intra-spinal injection and improving hemodynamic indices (heart rate and SaO2).

Background: Cancer is one of the common diseases in childhood, the diagnosis of which shocks parents, especially mothers. Meanwhile, parents’ adaptation to the disease reduces complications and problems. Objectives: Therefore, this study was aimed at exploring the impact of Roy adaptation model on care burden in mothers of children under chemotherapy. Methods: This quasi-experimental study was performed on 36 mothers of children under chemotherapy who had referred to the oncology ward of Taleghani Hospital, Gorgan, in 2018. Random sampling was carried out for both control and experimental groups. The experimental group received a training program based on Roy adaptation model during seven sessions over a four-week period. Data were collected using the Caregiver’ s Burden Scale (CBS) devised by Elmstahl. The results were analyzed in SPSS-18 using independent and paired t tests as well as covariance test at the signifi cance level of P < 0. 05. Results: The means of care burden before the intervention in the experimental and control groups were respectively 70. 44  7. 04 and 67. 11  6. 54. The independent t test did not reveal any signifi cant diff erence in this regard (P = 0. 15). However, after the intervention, the mean of care burden signifi cantly diff ered between the experimental (50. 94  4. 58) and control (70. 88  5. 13) groups, as confi rmed by independent t test (P < 0. 001). Conclusions: Based on the results, deploying the care program based on Roy adaptation model is an eff ective, low-cost, and noninvasive nursing intervention for mothers of children with cancer.