Cardiovascular Nursing Journal
Year:2015 | Volume:4 | Issue:3|Papers Count:7

Aim. This study was conducted to examine the effect of nursing ethics workshop on patients rights practiced by nurses in the emergency department.Background. According to the goals of 20 years vision and development plans of Iran, moving toward improving the quality and safety of patients and their rights are of the main priorities of health care system approved by national and international experts and authorities.Method. This study is quasi-experimental study with control group. To measure dependent variable (patient’s right practice by nurses), before and after intervention, perspectives of 180 patients admitted to emergency department were selected by convenience sampling. Intervention was implemented for emergency department nurses. All emergency department staff nurses working in a governmental hospital in the City Shahriar, Iran, were selected. The data were collected through a questionnaire composed of 2 parts, demographic information and 15 questions designed based on patients rights protocol in 5 domains with Likert scale. In order to ensure reliability, Cronbach’s Alpha was calculated for internal consistency coefficient through interviews with 20 patients (α=0.84). Validity of the questionnaire was evaluated by 10 experts. The questionnaire were completed before and one month after intervention through interviewing with patients admitted to the emergency department during the data collection time period. Data were analyzed by SPSS version 22.Findings. Before intervention, the mean score of patient’s right practice was 58.83±16.81 and after intervention, the mean score of patient’s right practice increased to 84±8.12. There was a statistically significant difference between the mean total score of patient’s rights practice based on patients perspectives, before and after intervention (p˂0.0001). The lowest score for patient’s rights practice was reported for the domain information giving (15%) and the highest score was reported for the domain respect for privacy (82.7%).Conclusions. The intervention (nursing ethics workshop) has a positive effect on patient’s rights practice by nurses in the emergency department.

Aim. The aim of this study was to determine the effect of patient education and nurse-led telephone follow-up (telenursing) on adherence to treatment in patients with acute coronary syndrome admitted to cardiac care units hospitals affiliated to Alborz University of Medical Sciences.Background. Increasing adherence to treatment is essential in patients with acute coronary syndrome to reduce readmissions and improve the recovery, but only patient education does not guarantee the adherence to treatment and it is necessary to follow-up patients after discharge.Method. This randomized clinical trial study was conducted on patients with acute coronary syndrome admitted to the selected hospitals of Karaj, Iran, in 2014. In this study, 90 patients were selected purposively and randomly allocated in three groups of education (n=30), education/ telephone follow-up (n=30), and control (n=30). Data collection instrument was questionnaire. Data were gathered at baseline and 12 weeks after the intervention. Patients in educational groups (education, and education/ telephone follow-up groups) were trained before discharge using educational pamphlets. Telephone follow-up were implemented for education/ telephone follow-up group for 3 months; twice a week in the first six weeks and weekly in the second six weeks. The data was analyzed by descriptive and inferential statistics in SPSS version16.Results. After intervention, there was a statistically significant difference between the groups in terms of adherence to treatment (P=0.001). Participants in the education/ telephone follow-up group and education group experienced more improvement in adherence to treatment than the control group.Conclusion. Both patient education and education/ telephone follow-up have effect on improvement of adherence to treatment, but education/ telephone follow-up results in more improvement in adherence in comparison to education. It is recommended to implement education/ telephone follow-up for patients with acute coronary syndrome.

Aim. The present study aims to determine the relationship between family performance indices (cohesion, expressiveness, and conflict) and the risk of myocardial infraction.Background. Cardiovascular diseases, especially myocardial infraction, is the first factor of fatality in the world and also in Iran. The etiology of myocardial infraction is a very complicated. One of the risk factors overlooked in the studies associated with the etiology of cardiovascular disorders is family and performance indices of the family.Method. The present research was conducted by a case-control cross-sectional design. The data were collected from two groups, a group of 50 patients with myocardial infraction symptoms (case group) referring to Heshmat Specialized Hospital for Cardiology in Rasht and Tehran Specialized Heart Center, and a group of 50 healthy persons (control group) with no symptoms of myocardial infraction. The data gathering tool included Family Relationships Index. The data were analyzed by SPSS version 16 using MANOVA method.Findings. There was a statistically significant difference between case and control groups in terms of control variables: history of myocardial infarction, education, history of smoking, history of cholesterol and hypertension (p<0.01), and history of diabetes (p<0.05). There was also a statistically significant difference between groups in terms of cohesion, and conflict indices (p<0.01).Conclusion. Deficiency in family performance indices, including cohesion, and conflict in family relationships, are among the main risk factors of myocardial infarction. Therefore, it is necessary to prepare and implement social, behavioral and educational interventions in order to prevent negative effects of inadequacies in family performance indices.

Aim. The aim of this study was to evaluate the ethical sensitivity and its relationship with demographic characteristics in critical care nurses of Shahid Rajaee Heart Center in Tehran.Background. Nurses are the largest group of service providers in the health care system, and must be aware of and sensitive to ethical issues related to their profession. Ethical sensitivity is the basis of ethics in nursing enabling nurses to take care of their patients effectively and ethically.Method. In this descriptive-analytical study, 181 nurses working in the intensive care units of Shahid Rajaee Heart Center hospital were randomly selected. Data were collected through demographic questionnaire and standard questionnaire of the nurses’ moral sensitivity. Moral sensitivity has six aspects: respecting the patient independence, awareness of how to communicate with patients, professional knowledge, experiencing the ethical problems, using moral concepts in decision-making ethics, integrity and benevolence. The data were analyzed based on SPSS version 19, using descriptive and inferential statistics.Findings. The mean score of nurses’ ethical sensitivity was 70.85±7.73 with the highest scores in the domain knowledge of how to communicate with patients and the lowest score was related to the domain the level of professional knowledge. Among the demographic variables, there was a statistically significant correlation of age, average weekly work hours, and years of working with ethically sensitive nurses; with the increase of age and experience, the moral sensitivity was also increased, while the ethical sensitivity decreased as a result of the increase of average weekly work hours.Conclusion. Considering that moral sensitivity in this study was moderate, it is recommended that nurse managers standardize the weekly working hours of the nurses in intensive care units in order to increase the ethical sensitivity in nurses.

Aim. This study was conducted to examine the effect of deep and slow breathing on pain and pain outcomes during arterial sheath removal after undergoing coronary angioplasty.Background. During the last 30 years, coronary angioplasty has been the most common method for management of coronary artery stenosis. Lack of control or treatment of the pain caused by arterial sheath removal may have some consequences, most notably increased heart rate and blood pressure in patients.Method. This is a clinical trial study conducted on 60 patients undergoing coronary angioplasty, hospitalized between April and August 2015 in the catheterization laboratory of Shariati hospital, Tehran, Iran. Patients were divided into two groups using random number table. The intervention was slow, deep breathing techniques by inhale and exhale ratio of 4 to 6. Data were analyzed using SPSS.Findings. Immediately and 5 minutes after sheath removal, the average pain score in the intervention group was significantly lower rather than control group (P<0.05). There was no statistically significant difference between groups in terms of blood pressure and heart rate average. The average number of vasovagal attack was significantly different between the groups. The average number of vascular complications was not significantly different between intervention and control group.Conclusion. The use of slow and deep breathing and relaxation technique is effective on pain management and the incidence of vasovagal attacks after arterial sheath removal, and can be used as an easy and safe method to decrease patients’ discontent caused by pain.

Aim. The aim of this study was to evaluate the effect of early mobility on respiratory parameters in patients after open heart surgery. .Background. Post-operative phase of open heart surgery is the most critical period during which many serious and fatal complication can occur. Early mobility can prevent such complications. The role of the critical care nurse is crucial in this regard.Method. In a randomized clinical trial, 104 patients who were candidate for open heart surgery were randomly assigned to experimental (n=52) and control (n=52) group. Patients in control group received hospital routine treatments. Patients in experimental group were mobilized from the bed in the first, second and third day after surgery. Early mobility included change position, siting on the bed, legs dangling off the bed, sitting in the chair next to the bed, and walking). The effect of early mobilization on respiratory indices was examined. Data were analyzed in SPSS version 18 using independent t-test, Chi-square and one way ANOVA statistical testes.Findings. There was no statistically significant difference between groups regarding demographic variables and underlying disease. Better lung function and arterial blood gases suitable changes were seen in the experimental group. Inspiratory capacity and arterial oxygen saturation was greater in the experimental than control group.Conclusion. Early mobility after open heart surgery is a safe and effective intervention and can have a positive effect on the patient's respiratory indices reducing pulmonary complications following surgery.

Aim. The aim of this review was to determine the clinical outcomes of blood transfusion in patients undergoing coronary artery bypass graft surgery.Background. Despite efforts to reduce the use of blood products in cardiac surgeries, its use is still high. Blood should be considered as a scarce source which can lead to some clinical outcomes.Method. In this paper, a review was conducted on the studies published between 2002-2015. The studies were searched out through scientific databases, including PubMed and Science Direct by the keywords blood transfusion, adverse effects, clinical outcomes, coronary artery bypass graft surgery and their Persian equivalents.Findings. The review of 15 studies revealed that survival rate 30 days and 1 year among patients received blood transfusion were significantly less than patients without blood transfusion. Mortality (short and long term) in patients with blood transfusion was significantly higher than patients without blood transfusion. Also, patients receiving blood transfusion had more complications including atrial fibrillation, infection, pneumonia and cerebral vascular accident as compared with patients without blood transfusion.Conclusion. Blood Transfusion increases mortality, hospital stay and several various complications. It is essential that policy of limited blood transfusion to be considered against free blood transfusion.