Background: The nursing workload has a close and strong association with the quality of services provided for the patients. Therefore, paying careful attention to the factors affecting nursing workload, especially those working in the Intensive care units (ICUs), is very important.Objectives: This study aimed to determine the factors affecting nursing workload in the ICUs of the hospitals affiliated to Tehran University of Medical Sciences.Materials and Methods: This was a cross-sectional and analytical-descriptive study that has done in Iran. All nurses (n=400) who was working in the ICUs of the hospitals affiliated to Tehran University of Medical Sciences in 2014 were selected and studied using census method. The required data were collected using a researcher–made questionnaire which its validity and reliability were confirmed through getting the opinions of experts and using composite reliability and internal consistency (α=0.89). The collected data were analyzed through exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and using SPSS 18.0 and AMOS 18.0.Results: Twenty-five factors were divided into three major categories through EFA, including structure, process, and activity. The following factors among the structure, process and activity components had the greatest importance: lack of clear responsibilities and authorities and performing unnecessary tasks (by a coefficient of 0.709), mismatch between the capacity of wards and the number of patients (by a coefficient of 0.639), and helping the students and newly employed staff (by a coefficient of 0.589).Conclusions: The nursing workload is influenced by many factors. The clear responsibilities and authorities of nurses, patients' admission according to the capacity of wards, use of the new technologies and equipment, and providing basic training for new nurses can decrease the workload of nurses.

Hand hygiene protocols in hospitals, particularly in Intensive care units, is recognized as one of the most important means to prevent and control the spread of health care-associated infections. Newborns in neonatal Intensive care units (NICUs) are at especially high risk of health care-associated infections because of a combination of innate characteristics including their fragile integumentary and underdeveloped immune systems as well as the frequent need for instrumentation (e.g. central venous catheters), invasive procedures and frequent contact with staff. Best practices for hand hygiene for such high risk patients include the cleaning or degerming of hands before and after patient contact, after touching patient equipment or environmental surfaces, before performing invasive procedures and after removing gloves. Because numerous factors could contribute to appropriate hand hygiene practices, it is critical to understand current behaviors of health care workers who contact high risk patients to develop appropriate, targeted interventions that might improve hand hygiene practices. These factors include the frequency of patient contact by different types of personnel, frequency of handwashing and gloving, the frequency of contact with the patients’ environment and equipment and the impact of different hand hygiene products. Conclusion: unfortunately, Hand hygiene of physicians and nurses in NICUs is low. Hand hygiene is significantly higher pediatric nurses than neonatal. Gloves and alcohol rub are not used according to recommended guidelines. Incorporating effective education programs that improve adherence to hand hygiene guidelines into the continuing education curriculum of health professionals is recommended.

Aims: Intensive care units are one of the hospital; codification of appropriate structural most sensitive parts of each standards and its measurement improve the quality of services in those units. So this study had been done with the aim of “determining structural conditions of Intensive care units.Methods: This cross-sectional study had been designed for measuring structural standards of Intensive care units in three areas of human force, physical conditions and medical equipment in educational hospitals of Hamadan and comparing it with the last existing standards according to international guidelines and principles and accreditation standards of Iranian hospitals and it had been performed from April to September of 2011. Data were collected via completing assessing forms with direct observance of the researcher and they had been analyzed by using statistical tests, ANOVAs (variance analysis) and Spearman in SPSS (17) software area.Results: All the three units of the study achieved less than 50% score of structural standards among total 843 scores that Besat Intensive care unit 48% (the mean score 406) Ghaem Intensive care unit 45% (the mean score 376) and Milad Intensive care unit had 41% ( the mean score 346) of the standards. The most percent of the standard score was related to human force with (%58) and the least one was related to physical conditions and facilities with (%38).Conclusion: In Intensive care units of the study, achieved scores in structural domination was less than appropriate standard level. Therefore it had been suggested that the executives consider achieving global standards specially promotion of structural standards that is guarantor of quality promotion and optimization performance of Intensive care units.

Palliative care is a series of actions aiming to offer support to parents and their infants in order to improve their quality of life. Despite optimal outcomes, the provision of palliative care for infants and achieving these outcomes may be hardly feasible. The present study aimed to investigate the barriers to palliative care and gain insight into the solutions. Accordingly, the obstacles were identified and classified into three categories of parent-related barriers (parental request for continuing treatment, cultural background, and religious beliefs), barriers concerning healthcare providers (attitude toward palliative care, death, and life values, religious beliefs, knowledge and skills in palliative care, and ethical distress), and barriers within the healthcare system (unclear policies regarding the implementation of palliative care, inadequate support from caretakers, lack of educational programs, insufficient personnel, unprepared environment, lack of technological requirements, and lack of access to consultants). Each category was discussed, and relevant solutions were provided.

Background: One of the most common problems in Intensive care units (ICUs) is pressure ulcer or bed sore and its prevention is a priority in nursing cares.Objectives: The current study aimed to evaluate the effect of henna (Lawsonia inermis) on prevention of pressure ulcers in patients in ICU.Patients and Methods: The current randomized clinical trial was conducted on 80 patients with the inclusion criteria hospitalized in the ICU of Al-Zahra hospital, Isfahan, Iran in 2015. Patients were randomly allocated into two groups of control (40 patients) and intervention (40 patients) by drawing method. For the intervention group, along with the standard prevention cares for pressure ulcers, once a 15cmthick layer of henna was appliedonpatients’ sacrum. Data was gathered using demographic data questionnaire, Braden scale to predict pressure ulcer risk and the table to control daily record of skin temperature before the intervention for a week. Data were analyzed using SPSS ver.21 and Chi-square, Greenhouse Geisser, Pearson correlation coefficient and independent t-test were used in the study.Results: The mean age of patients in the intervention and control groups was 51.35  17 and 52.94  19.61years, respectively. The means of standard deviation score of the Braden scale for all the participants on the first, fourth and seventh day of the study were 12.272.85, 14.233.21 and 15.733.82, respectively, which had significant differences with each other (P<0.0001); suggesting that the risk of pressure ulcers occurrence was higher on the first day than the seventh day. There was a reverse relationship between reduction of the Braden scale score and increase in local warmth of sacrum (r=0.558) in both groups. The mean and standard deviation of local warmth of sacrum during the seven days of study were 37.84 0.52 and 38.06  0.67 in the intervention and control groups, but their difference was insignificant (P<0.14). The mean and standard deviation of local warmth of forehead during the seven days of study were 37.090.41 and 37.030.44 in the intervention and control groups but their difference was insignificant (P<0.5). There was a statistically significant difference between the mean local warmth of sacrum and forehead in the intervention group during the seven days of study (P=0.0001). At the end of the study, one patient in the intervention group (2.7% male) and six patients in the control group (14.29% male, 2.85% female) had developed pressure ulcers; this difference was significant (P=0.001).Conclusions: Considering the effect of henna in reducing the local warmth, redness, and inflammation of sacrum in patients in Intensive care units, application of hennato prevent pressure ulcers for patients at risk of developing pressure ulcers isrecommended.

Introduction: Nurses in the Intensive care unit experience job conflicts due to the poor con-dition of patients and the complexity of the work environment. If these conflicts are not iden-tified and managed, they can lead to problems, violence in the workplace, reduced motiva-tion, and quality of nursing care and thus harm to patients. Methods: The study was a descriptive-analytical research. The study population included nurses of Intensive care units of educational and medical centers and social security hospitals in Ardabil, from which 240 people who were eligible to enter the study were selected. The data collection tools were demographic data form and Dubrin conflict levels and Robbins conflict management strategies questionnaires. Data were analyzed by SPSS v. 23 using de-scriptive (frequency, mean and standard deviation) and analytical statistics (Pearson correla-tion coefficient, t-test and ANOVA). Results: According to the results, most nurses (84. 2%) experienced moderate levels of conflict. Nurses were using conflict management styles of avoiding (44. 92±, 11. 52), solution-oriented (38. 27±, 11. 72) and control (30. 44±, 8. 53) respectively. There was a significant rela-tionship between nurses' job conflict with hospital (P=0. 01) and workplace ward (P=0. 025). Also, the relationship between conflict management strategies with age, sex, employment sta-tus and workplace of nurses was significant (P<0. 05). Conclusions: Most nurses experienced moderate levels of conflict and they used the avoid-ance strategy to manage conflicts. Therefore, it is recommended that nursing managers, by adopting appropriate methods for resolving conflicts, help reduce them in the workplace and thus improve the quality of nursing care.