IRANIAN JOURNAL OF EMERGENCY CARE (IJEC)
Year:2017 | Volume:1 | Issue:3 |Papers Count:9

Background and Objectives: Caring is the core of the nursing profession, and in order to deal with ethical problems in caring for patients, nurses need to enjoy a high level of moral reasoning. Moral reasoning is the ability of the person to judge correctly in the face of ethical issues. This study aimed to determine the relationship between ethical reasoning and care behaviors of nurses in the emergency department due to the necessity of using ethical reasoning for ethical-based care. Materials and Methods: Through descriptive-analytic cross-sectional study 272 nurses participated in the study using the convenience method. Data were gathered using demographic information questionnaire, standard care behavior questionnaire, and Crisham’ s nursing dilemma test. Data were analyzed by descriptive statistics, independent t-test, ANOVA, Pearson correlation coefficient and multivariate regression using SPSS software ver. 22. Results: The mean scores of nurses’ ethical thinking, clinical considerations and nurses’ caring behavior were 45. 10± 7. 22, 21. 67± 3. 72 and 4. 65± 0. 42, respectively. In multivariate analysis, a positive and significant relationship was found between moral reasoning and care behavior (β =0. 019, p<0. 001). Conclusion: Due to the direct relationship between ethical reasoning and care behavior, it seems that promoting ethical reasoning of nurses can be effective in promoting their better performance and increasing the quality of care.

Background and Objectives: Trauma is a health problem that is increasing throughout the world. The use of preventive methods in the field of trauma will be effective when the correct information about the types of trauma and their related factors are available. The aim of this study was to determine the characteristics of trauma patients, types of trauma and their related factors in trauma patients referred to the emergency department of Ayatollah Mousavi teaching hospital affiliated to the Zanjan University of Medical Sciences. Materials and Methods: In this descriptive cross-sectional study, demographic data and trauma-related factors were collected through data sheets of 154 trauma patients who referred to the emergency department of Ayatullah Mousavi's Emergency Department between November 22, 2017, till March 20, 2018. Data were analyzed by SPSS software version 21 using descriptive and inferential statistics. Results: The results of this study showed that there is a significant statistical relationship between the type of trauma and gender (p=0. 047), and all age groups are at the same risk for motor vehicle crashes on intercity roads than other types of trauma mechanism (p=0. 039). In terms of causes of trauma, motor vehicle crashes with 53. 9%, falling with 28. 6%, and injuries due to tissue crush with 10. 4% were the most common causes of trauma. Conclusion: The results of the study showed that trauma patients’ recorded data may be considered as a priority in dealing with trauma. Preventive interventions are required for a variety of causes and mechanisms of trauma and promoting the quality of hospital and pre-hospital services can reduce its harmfulness burden on the health system.

Background and Objectives: Emergency medical profession is inherently stressful; medical emergency technicians experience a lot of stress due to the workplace and conditions of patients. The rate of exposure to stressors effects on the staff’ s health and patients’ care. This study aims to determine the rate of exposure to stressors among EMTs in the East Azerbaijan province. Materials and Methods: In this descriptive cross-sectional study, 320 EMT from 98 emergency departments of East Azerbaijan province participated. To collect data, stressor exposure questionnaire were used. Data were analyzed by SPSS software and using descriptive and inferential statistics. Results: The results of this study showed that among 45 experienced occupational stressors, the mean rate of exposure was 2. 79 out of 5. The highest mean rate of exposure to stressors was 3. 76 which included the transfer of critical ill patients with ambulance to the emergency departments and the lowest mean rate of exposure was 2. 06 which included the lack of knowledge in utilizing the equipment appropriately. Also, there was a significant relationship between the rate of exposure with occupational stressors and the number of missions, educational qualifications and employment type. Conclusion: In this study, rate of exposure to stressors was moderately high among emergency medical staff. Identifying the rate of exposure to stressors can be effective in planning and prevention in order to reduce and control the rate of exposure to stress among emergency medical technicians.

Background and Objectives: Identifying maternal and neonatal risk factors and timely resuscitation at birth can lead to the prevention of asphyxia, which is the third leading cause of neonatal death in the world. Therefore, this study was conducted to determine the need for neonatal resuscitation and its related factors in the delivery rooms of hospitals in Zanjan province. Materials and Methods: This cross-sectional study was performed in two years. The prevalence and risk factors of neonatal resuscitation, resuscitation processes, and its short term prognosis were extracted. Data were analyzed by using univariate and multivariate logistic regression with SPSS18 software. Results: Results showed that 9. 9% of newborns needed initial resuscitation and 1. 5% needed advanced resuscitation. Cesarean delivery and normal delivery by means of forceps or vacuums, maternal diseases, and interventions during labor increased the chance for the need of resuscitation. Also, for each week increase in the gestational, one gram increase in newborn weight, and an mother educational level the probability of the need for a newborn resuscitation is reduced. Conclusion: Delivery type, maternal underlying diseases, interventions during labor, maternal demographic factors, gestational age and newborn’ s weight were the most important risk factors associated with the need for resuscitation. Identifying the predictors need for newborn resuscitation is important for planning and effective interventions.

Background and Objectives: In the healthcare team, the pre-hospital emergency medical technicians are the first individuals who encounter forensic issues. This study aims to determine the status of knowledge, attitude, and performance of emergency medical technicians on forensic issues in Kashan, 2017. Materials and Methods: This descriptive study was conducted with the participation of 110 emergency medical technicians in Kashan through using a census. Data were collected by using demographic characteristics and a researcher-made knowledge, attitude and performance questionnaire. The researcher-made questionnaire consisted of 42 questions, and each of knowledge, attitude and performance section had 10, 10, and 22 questions, respectively. Data were analyzed by using descriptive statistics, t-test, chi-square and ANOVA and SPSS 16 software. Results: This research shows that the mean scores of knowledge, attitude, and performance of emergency medical technicians on forensic issues were 5. 69 ± 2. 14, 30. 95 ± 9. 26 and 14. 95 ± 4. 40, respectively. Findings indicated that knowledge, attitude, and performance status are significantly related to educational level (P <0. 001) and type of employment (P <0. 01) and have no relationship with age, background, and type of education. Conclusion: Knowledge, attitude, and performance of Kashan medical emergency technicians related to forensic issues were at a medium level. Updating the knowledge, attitude, and performance of emergency medical technicians in this area is important to discover or to clarify forensic records and to protect the relevant evidence.

Background and Objectives: Patients referred to emergency departments need immediate medical proceedings by personnel of the emergency department. Time managing is vital to present medical service and its failure can endanger patients' lives. This study aimed to determine time indices and its related factors in the emergency department of selected hospitals of Qom University of Medical Sciences. Materials and Methods: In this descriptive-analytic study, 250 patients who referred to the emergency department were selected by convenience sampling. The tool for collecting data was the revised form of "time indices and workflow of emergency services" and chronometer. Data were analyzed by SPSS Ver. 23 non-parametric tests including Mann Whitney and Kruskal Wallis. Results: Patient’ s entry time to triage was 7/2± 13/2 minutes, time of triage to doctor's visit was 21/3± 37/8 minutes, time of physician’ s visit to decision making was 28/9± 40/5 hours, time of decision making till departure was 8± 60/5 hours, and total time of arrival at and departure from the department was 15/4± 17/07 hours. There were significant differences between the mean of the studied time in terms of marital status, severity of illness and cause of illness (p <0. 05), so that the highest mean of total arrival time till departure was in married patients, and patients with urgent and internal causes. Conclusion: Observing time indices in emergency departments of hospitals requires time management of the authorities. Achieving an international standard requires to reform the policies, principles and hospital management executive processes. Policy-making should be based on organizing therapeutic measures, preventing congestion and preventing from its adverse effects on patient care.

Background and Objectives: Educating medical students on how to manage emergency patients and how to perform in emergency situations is critical. The aim of this study was to evaluate the effect of emergency department training on promoting clinical preparedness and satisfaction of medical interns in the Emergency Department of Ayatollah Mousavi, teaching hospital of Zanjan University of Medical Sciences in 2015. Materials and Methods: This is a descriptive-comparative study in which 56 medical interns were studied during one month of emergency medicine course at Ayatollah Mousavi as a teaching hospital. In this one-month course, interns attended the theoretical and internship classes in the emergency department. Clinical preparedness and their satisfaction from internship before and after the course were evaluated with the same tools and the results were compared. Content validity of the questionnaires was reviewed by 3 medical emergency specialists and Cronbach’ s alpha method was used to determine the reliability of the questionnaire, which was 82%. Data were analyzed by using descriptive statistics and paired t-test through SPSS software version 16. Results: The results showed that the mean and standard deviation of interns' pre-test scores (9. 3 ± 1. 84) and the mean and standard deviation of post-test scores (13. 73± 1. 94) were significantly different (P< 0. 001). In all cases, post-test scores were significantly higher than pre-test scores. 66. 9 percent of the interns had from good to excellent satisfaction from the medical emergency course. Conclusion: Theoretical and practical education in the emergency department affected clinical interns' preparedness and the majority of interns were satisfied with the education of this department.

Background and Objectives: Bioterrorism is an important health issue worldwide. The readiness to reduce death due to bioterrorist attacks depends on access to efficient resources and forces. The best way to defend is to raise the level of people's defense knowledge. Meanwhile, increasing students' knowledge is of paramount importance. Therefore, the present study aims to determine the effect of bioterrorism education through holding a workshop and offering an educational manual on nursing students’ knowledge. Materials and Methods: This quasi-experimental study was carried out on 90 undergraduate nursing students of Hamedan nursing and midwifery. Students were randomly assigned to two groups of intervention and control. Firstly, using a researcher-made questionnaire, the knowledge of nursing students from different areas of bioterrorism was evaluated. The intervention was in the form of holding a workshop and offering a manual. Two weeks after education, the questionnaire was completed and evaluated again. Results: Based on the paired t-test, the mean scores of students' knowledge about bioterrorism before and after education were significantly different in the intervention group (P<0. 001). But there was no significant difference between mean scores of the control group before and after education (p=0/504). The results of independent t-test showed that there was no significant difference in the mean scores of students’ knowledge before education in both intervention and control groups (p=0. 253). But the mean scores after education were different in the two groups and were significantly higher in the intervention group than the control group (P<0. 001). Conclusion: According to the results of this and similar studies, education contributes to the increase in nursing students ‘ knowledge about bioterrorism attacks.

Background and Objectives: Offering pre-hospital emergency services always puts staff at the risk of contracting or spreading infectious diseases in the community. Compliance with standard precautions is an essential part of the performance of these staff. The purpose of this study was to measure the knowledge and performance of pre-hospital emergency staff regarding infection control standard precautions. Materials and Methods: This cross-sectional analytical study was carried out on 160 pre-hospital emergency staff working in emergency operations unit of Hamedan and Kermanshah provinces. Convenience sampling was used in this study. Data was collected using a reliable and valid questionnaire on knowledge and performance of these staff regarding infection control standard precautions. Data were analyzed by SPSS software version 21. Results: The mean age of the individuals was 33. 24± 7. 38. More than one-third of individuals (34. 37%) had a history of the needle stick. There was no significant relationship between knowledge and performance (p<0. 05), but there was a significant relationship between the knowledge variable and the level of education (p<0. 05). The mean knowledge score of the samples regarding infection control standard precautions was 47. 15± 15. 28 at a low level and the mean score of the performance of the sample was 56. 66± 11. 87 at a moderate level. Conclusion: According to the results of this study, most of the staff did not have good knowledge and performance regarding the principles of infection prevention. Therefore, authorities should pay more attention to take necessary measures for the education of pre-hospital emergency staff.