@article{ author = {Javadinejad, Mohammad and Bahramnezhad, Fatemeh}, title = {Investigating Nurses’ Views of the Quality of Dying and Death in Intensive Care Units of Hospitals Affiliated with Tehran University of Medical Sciences in 2023: A Cross Sectional Study}, abstract ={Background & aim: Thinking about death is a human cognitive activity which affects a dying patient and the individuals who take care of them, especially nurses. Considering the high mortality rate in ICUs, the present study aims to determine the views of the nurses of ICUs regarding patients’ quality of dying and death. Methods: This descriptive-cross-sectional study was conducted in 2023 in hospitals affiliated with Tehran University of Medical Sciences. The research population consisted of 176 ICU nurses in hospitals affiliated with Tehran University of Medical Sciences, who were selected via a convenient sampling method. The data was collected using a demographic survey and the Quality of Dying and Death (QODD) Questionnaire —Version 3.2a by Cho et al. (2017). Results: In evaluating the quality of dying and death and its three components (patient’s experience at the end of life, end-of-life medical care, and quality of the moment of death experience), it can be stated that all of these components were lower than the mean scores. Therefore, from the nurses’ viewpoints, the quality of dying and death and its components are lower than mean scores. Regarding the demographic characteristics (gender and marital status), there was no significant difference in the quality of dying and death of terminally ill patients in ICUs of hospitals affiliated with Tehran University. In regards to nurses’ education and their received training in the field of quality of dying and death, a significant difference was observed (P<0.05). Conclusion: Regarding nurses' understanding of the quality of dying and death in ICUs, planning can be done to help preserve the human dignity of dying patients and the peace of their families by creating supportive measures. Through this process, families can also be assured that by maintaining the patient's human dignity, their death can be more convenient, and can be a foundation for knowledge in this field.}, Keywords = {Quality of Dying and Death, ICU, Nurse}, volume = {17}, Number = {2}, pages = {1-9}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491.17.2.1}, url = {http://jccnursing.com/article-1-759-en.html}, eprint = {http://jccnursing.com/article-1-759-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2024} } @article{ author = {Farahdel, Mahdi and Inanlou, Mehrnoosh and Haresabadi, Mahdi and Poorbarat, Salar and Khorashadizadeh, Fatemeh}, title = {Exploring Factors related to the Stress Caused by Patients\' Delirium Experience in Nurses Working in Intensive Care Units of the Selected Educational and Medical Centers in North Khorasan Province and Khorasan Razavi Province: A Cross Sectional Study}, abstract ={Background & aim: Nursing is a stessful perofesion due to its nature of the job. This study was designed and conducted in order to determine the stress caused by patients' delirium experience in nurses of Intensive Care Units (ICUs) of selected educational and medical centers in North Khorasan and Razavi provinces in 2018. Methods: This descriptive- analytic research was conducted on 170 nurses working in adult ICUs using the convenience sampling method. Stress caused by delirium in this study was examined applying the Delirium-induced experience and stress (CEDD'S) instruments of ICUs. Results: In this study, most participants were women (79.4%) and had a mean age of 35 years (33%). The research findings explaines that most nurses (75.88%) expressed their stress in the medium range. The results of statistical tests revealed that a statistically significant relationship was only observed between the work experience of nurses and the stress produced by patients' delirium experience (P = 0.020). Conclusion: Considering the existence of moderate stress in special department nurses and its significant relationship with work experience, it seems that nursing managers should reduce the stress of special department nurses with proper planning and stress management training.}, Keywords = {Stress, Delirium, Nurses, Intensive Care Unit}, volume = {17}, Number = {2}, pages = {10-16}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491.17.2.10}, url = {http://jccnursing.com/article-1-766-en.html}, eprint = {http://jccnursing.com/article-1-766-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2024} } @article{ author = {Babaei, Keivan and Abdi, AliReza and Ghesmati, Faezeh and Nowzari, Amir Hossein and Goodarzi, Afshi}, title = {Explanation of the Organizational Dimensions Affecting the Resuscitation Process: A Qualitative Study}, abstract ={Background & aim: Despite the ever-increasing number of patients with cardiopulmonary arrest, the survival rate of patients has decreased. On the other hand, this index has been reported differently in different countries. The difference in the outcomes of resuscitation, despite following a single guideline, indicates that several factors are effective in the optimal performance of the resuscitation process and its outcomes. This study aimed to explore the perceived organizational dimensions effective on cardiopulmonary resuscitation from the perspective of the members of the resuscitation team. Methods: The present study was conducted with a qualitative approach. The sample of our study included 23 members of the resuscitation team who were selected purposefully from February 2024 to May 2024 with maximum diversity. In-depth semi-structured interviews were used to collect data. Data were analyzed using qualitative content analysis with the conventional approach of Graneheim and Lundman (2004). Results: The organizational dimensions effective on cardiopulmonary resuscitation were developed in three main categories and eight subcategories. Perceived convergence and divergence in the resuscitation team members with three subcategories, organizational ambiguity in the resuscitation process with two subcategories and the importance of support organization for proper resuscitation with three subcategories, were the three main extracted categories in the present study. Conclusion: The managers should put an all-round approach based on the perception of the rescuers in the promotion of this process. Creating grounds for promoting convergence between resuscitation team members, developing clear guidelines for do-not-resuscitate, clinical or simulator-based training, re-engineering of the resuscitation room along with motivational approaches for resuscitation team members can be considered in planning to improve the resuscitation process in organizations.}, Keywords = {Cardiopulmonary Resuscitation, Qualitative Study, Rescuer, Organization}, volume = {17}, Number = {2}, pages = {17-26}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491.17.2.17}, url = {http://jccnursing.com/article-1-781-en.html}, eprint = {http://jccnursing.com/article-1-781-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2024} } @article{ author = {Heydarian, Mohammadhossein and VahedianAzimi, Amir and Mahmoodi, Hossein and Vafadar, Zohreh}, title = {Effect of Adaptive Support Ventilation on the Outcomes of Intensive Care Unit Patients: A Systematic Review Study}, abstract ={Background & aim: A large number of patients are admitted to Intensive Care Units (ICUs) due to the need for mechanical ventilation. In mechanical ventilators, various modes and settings are used according to the patients' needs, which can significantly impact patient outcomes. One of these modes is Adaptive Support Ventilation (ASV), for which more evidence is needed regarding its effects. This study aims to elucidate the impact of ASV on the outcomes of patients admitted to ICUs. Methods: This systematic review study was conducted by searching relevant sources from the beginning up to April 5, 2023, in both English and Persian, with no time limitations on articles. The literature search was performed using Persian keywords including 'adaptive support ventilation,' 'intensive care,' 'patient outcomes,' 'mechanical ventilation,' and their English equivalents: 'adaptive support ventilation,' 'ASV,' 'intensive care,' 'critical care,' 'mechanical ventilation,' 'patients outcomes' in Persian-language databases such as SID, MagIran, IranMedex, and IranDoc, as well as English-language databases including Scopus, Web of Science, PubMed, Cochrane, EMBASE, ScienceDirect, and ProQuest, along with the first 30 pages of the Google Scholar search engine using the AND and OR operators. The selected articles were then categorized and entered the final stage for data extraction. Results: Out of 492 retrieved articles, 130 were included in the final stage of the study. A total of 107 studies reported outcomes on the impact of ASV, including reduced weaning time, lung protection and safe ventilation, reduced hospital stay duration, less clinical intervention, and reduced manpower requirements. Two studies examined the weaning duration and the impact of this mode on children and adolescents. Eleven studies did not observe any effects on weaning or the protective impact of this mode, and finally, ten studies reported complications associated with ASV. Conclusion: According to findings it can be stated that the use of ASV can reduce the patient's need for a ventilator and the number of breaths, while increasing tidal volume to prolong exhalation time in patients with Chronic Obstructive Pulmonary Disease (COPD) and reduce air trapping. This mode is recommended for patients in ICUs after heart surgery that needs rapid extubation. However, caution is advised when using it in children, infants, and obese patients who have undergone open-heart surgery. In addition, ASV can be used as an effective intervention for patients in ICUs.}, Keywords = {Adaptive Support Ventilation, Intensive Care Unit, Mechanical Ventilation}, volume = {17}, Number = {2}, pages = {27-45}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491.17.2.27}, url = {http://jccnursing.com/article-1-761-en.html}, eprint = {http://jccnursing.com/article-1-761-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2024} } @article{ author = {AlirezaeiDiziche, Maryam and Salmani, Fatemeh and Jouzi, Mi}, title = {The Effect of Nursing Counseling on the Family Syndrome of a Patient Hospitalized in an Intensive Care Unit: A Semi-Experimental Study}, abstract ={Background & aim: A patient's admission to the Intensive Care Unit (ICU) is a stressful experience for the patient's family. One of the problems that arise for the family members of patients hospitalized in ICUs is the occurrence of a series of psychological and non-psychological symptoms called syndrome of the patient's family in the ICU. This study was conducted with the aim of determining the effect of nursing counseling on the family syndrome of a patient admitted to the ICU. Methods: This semi-experimental study was conducted in 2023 in the city of Isfahan. For this purpose, 60 family members of patients admitted to the ICU were included in the study as available sampling. Then, by random allocation using the case number, they were placed in two intervention and control groups of 30 people. In the intervention group, nursing counseling in the form of getting to know the department, receiving an information booklet and holding two to three face-to-face meetings according to the needs of the family were included. They were given to family members individually and at most for half an hour. The control group only received routine ward care. Dass 21 Stress, Depression and Anxiety Questionnaires, FOA post-traumatic stress disorder, Petersburg sleep disorder, Chalapi and Amirkafi social isolation were completed by the samples in three stages (before the intervention, after the intervention, and one month after the intervention). Results: The findings of the study showed that nursing counseling has important changes on family syndromes including depression, anxiety, stress and post-traumatic stress disorder, and sleep disorders (P<0.001). However, there was no significant difference between the intervention and control groups on social isolation (P>0.001). Conclusion: According to findings, conditions should be provided to allocate appropriate time for nursing consultation for the family members of ICU patients.  It is also suggested to health managers that in ICUs, special attention should be paid to the patient's family as a unit of care.}, Keywords = {Nursing Consultation, Family Syndrome, Patient, Intensive Care Unit}, volume = {17}, Number = {2}, pages = {46-57}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491.17.2.46}, url = {http://jccnursing.com/article-1-776-en.html}, eprint = {http://jccnursing.com/article-1-776-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2024} } @article{ author = {Mahmoudilerd, Fateme and Navab, Elham and Haghani, Hamid and Shali, Mahboobe}, title = {Nurses\' Perception of their Role in the Active Participation of Family Caregivers in the Care of Patients Hospitalized in the Intensive Care Unit: A Cross-Sectional Study}, abstract ={Background & aim: The role of family caregivers is recognized as an important principle in advancing care goals. Knowing the importance of the role of nurses in the participation of family caregivers in the matter of care is important in achieving the goals of family-centered care. The present study was conducted with the aim of determining the nurses' understanding of their role regarding the active participation of family caregivers in the care of patients hospitalized in the Intensive Care Unit (ICU). Methods: In this cross-sectional study in 2024, 150 nurses working in ICUs affiliated to Tehran University of Medical Sciences were selected using proportional stratified sampling. In order to collect information, two questionnaires were used, including demographic information and a questionnaire on the nurses' understanding of their role towards family caregivers. Results: The nurses participating in the research had an average age of 34.6±7.88, and most of them were female (77.3%) and 62% were married. The average score of nurses' understanding of their role was 40.79 ± 6.87 (moderate understanding). Based on the statistical analysis, the nurses' understanding had a statistically significant relationship with the participation of family caregivers in patient care (P = 0.004). Conclusion: The results of the study showed that nurses had a moderate understanding of their role towards family caregivers in active participation in patient care. Given the importance of nurses' understanding of the active participation of family caregivers, it is recommended to carry out managerial and organizational interventions and provide the necessary conditions to promote a family-centered care culture in the care system.}, Keywords = {Family-Centered Care, Family Caregivers, Intensive Care Units, Nurses}, volume = {17}, Number = {2}, pages = {58-65}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491.17.2.58}, url = {http://jccnursing.com/article-1-787-en.html}, eprint = {http://jccnursing.com/article-1-787-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2024} } @article{ author = {Yavari, Mahdieh and Bahrampouri, Saiede and Nejat, Nazi and Javaheri, Jav}, title = {The Relationship between Apache 2 and PSI Scores with Length of Hospitalization and Mortality Rate of Covid-19 Patients Hospitalized in Intensive Care Unit: A Cross-Sectional Study}, abstract ={Background & aim: In Intensive Care Units (ICUs), several systems are used to predict patient mortality. In this study, the relationship between the Apache 2 and PSI scores with the length of stay and mortality rate of Covid-19 patients admitted to the ICU was investigated. Methods: This cross-sectional analytical study was conducted on patients admitted to the ICU. In order to collect information, the PSI and Apache 2 tools were used. After obtaining a referral from the university's research vice chancellor, the hospital archives unit was referred. Then, the data required for the Apache 2 tool, the PSI tool, and demographic characteristics related to the first 24 hours of admission to the ICU were collected from the hospital's files and HIS. Information related to the time of death, length of stay, and patient transfer were also recorded. Results: Of the 486 investigated patients, the mean and standard deviation of age was 62.76 ± 18.1. In addition, 46.7% of patients were female (227 patients) and 53.3% (259 patients) were male. The mean duration of hospitalization in the ICU was 7.15 ± 4.6 days (minimum 1, maximum 27 days). Furthermore, 21% (102 patients) were intubated at the time of examination. Finally, 51.9% (252 patients) were discharged from the ward and 48.1% (234 patients) died. In a recent evaluation, it was observed that the Apache 2 score had a statistically significant relationship with patient mortality, and the mean and standard deviation of the score were higher in deceased patients (P = 0.000). This tool can also predict the mortality rate of Covid-19 patients by 72.4%. The Apache 2 score was related to the patient's age and intubation status (P = 0.001), but it was not statistically significantly related to gender and length of hospitalization (P = 0.905). The PSI score had a statistically significant relationship with patient mortality, and the mean and standard deviation of the score were higher in deceased patients (P = 0.001). The PSI score also had no statistically significant relationship with length of hospitalization (P = 0.581). This tool can predict the mortality rate of Covid-19 patients by 66%. Also, according to the results of the recent evaluation, length of hospitalization was not related to the patient's age, gender, intubation status, and initial level of consciousness. Conclusion: According to findings, the use of the Apache 2 tool in the admission of patients with Covid-19 to the ICU had a more accurate prediction than other tools and could greatly contribute to the optimal use of ICU beds.}, Keywords = {Keywords: Apache 2, Pneumonia Severity Index, Length of Hospitalization, COVID-19}, volume = {17}, Number = {2}, pages = {66-75}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491.17.2.66}, url = {http://jccnursing.com/article-1-783-en.html}, eprint = {http://jccnursing.com/article-1-783-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2024} } @article{ author = {AbasiNiasar, Alireza and Mahmoudi, Hosein and Moradian, ُSeyed Tayeb and Vafadar, Zohreh}, title = {Evaluation of the Intra-Hospital Transfer Process for Critically Ill Patients in an Emergency Department of a Univesitiy\'s Hospital in Tehran: A Cross Sectional Study}, abstract ={Background & aim: Intrahospital patient transfer, particularly for critically ill patients in the emergency department, plays a crucial role in patient recovery and reducing mortality rates. Numerous factors, including coordination and time management, influence this process. A thorough examination of patient transfer procedures within hospitals can significantly contribute to identifying challenges and enhancing healthcare services. This study aimed to investigate the process of transferring critically ill patients within the emergency department. Methods: A descriptive-analytic study was conducted in 2023. The study population consisted of critically ill patients requiring admission to Intensive Care Units (ICUs). A sample size of 100 patients was selected using a convenience sampling method, considering the sample size formula and previous studies. Data was collected using a patient transfer safety and demographic questionnaire through observation and patient records. Results: An evaluation of the physiological parameters of critically ill patients during the transfer process revealed significant changes in blood pressure (P<0.05), while changes in other physiological parameters such as respiratory rate and heart rate were not significant (P>0.05). Out of 100 transfers, adverse events were observed in 12 patients. The most common adverse event reported was hemodynamic instability in 12 cases (12%). A significant correlation was found between the occurrence of intra-transfer disturbances and the implementation of standards for transferring critically ill patients. Non-compliance with transfer standards at certain stages of the transfer process, such as checking patients' blood pressure medications and using infusion pumps, led to adverse events and unfavorable changes in the health status of critically ill patients. Conclusion: The process of transferring critically ill patients in the emergency department was associated with adverse events that have a significant impact on patient outcomes. These findings highlight the importance of evaluating the transfer of critically ill patients in the emergency department. Strategies such as transferring critically ill patients by a trained team, using appropriate equipment and checklists, and avoiding the transfer of patients with unstable clinical conditions are effective.}, Keywords = {Adverse Events of Transfer, In-Hospital Patient Transfer Standards, Critically Ill Patients, Transfer to Intensive Care Unit}, volume = {17}, Number = {2}, pages = {76-84}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491.17.2.76}, url = {http://jccnursing.com/article-1-794-en.html}, eprint = {http://jccnursing.com/article-1-794-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2024} }