@article{ author = {Karami, Ata and Majedi, Mohammad azad and Kamyari, Naser and Vatandost, Salam}, title = {Knowledge and Practice of Nurses in Preventing Catheter Associate Urinary Tract Infection (CAUTI) in ICU: A Cross Sectional Study}, abstract ={Background & aim: Urinary tract infection is one of the most common hospital associate infections in the intensive care unit (ICU). The way nurses care for urinary tract catheters is one of the most important factors affecting the prevalence of urinary tract infection. Therefore, the present study was conducted to determine the knowledge and performance of nurses in preventing catheter associate urinary tract infection (CAUTI) in ICU. Methods: The study was conducted cross-sectional. Number of 105 ICU nurses were enrolled in the study using a complete census method. Nurses' knowledge and performance in preventing CAUTI were collected using standard questionnaires in a self-report manner. The knowledge questionnaire consists of 27 questions that are reported with correct and incorrect answers. The average percentage of correct answers of 80 and above is interpreted as good knowledge. The performance questionnaire consists of 23 questions with four-choice Likert-type responses ranging from completely agree (score 4) to completely disagree (score 1). An average score of 3 and above is considered good performance. Results: The mean age of the participants were 27.3 ± 3.03 years. Only 16.2% had a history of participating in a UTI prevention workshop. The results showed that only 38.1% of the knowledge and 33.3% of the performance of nurses in preventing CAUTI were at a good level. The highest incorrect response in the knowledge section was observed in the question "Does the placement of a urinary catheter help to heal bedsores in female patients with bedsores" (68.6%) and in the performance section was observed in the question "While caring for a female patient, I wash the perineum from back to front" (1.68 ± 0.68). Conclusion: The majority of nurses had poor knowledge and performance in preventing catheter-related urinary tract infection. Also, the majority of nurses did not have experience in specific training on UTI prevention in refresher courses. Given the importance of nurses' role in preventing catheter-related urinary tract infections, it is necessary to improve nurses' knowledge and performance based on standard protocols in academic training and refresher courses.  }, Keywords = {Urinary Tract Infection, Urinary Catheter, Nurse, Knowledge, Performance}, volume = {17}, Number = {4}, pages = {1-8}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.4.1}, url = {http://jccnursing.com/article-1-804-en.html}, eprint = {http://jccnursing.com/article-1-804-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2025} } @article{ author = {Fazljoo, Seyede Elham and Azizadini, Seyed Shahabadin and Dehghani, Abasali and Salmani, Ebrahim and Nasiriani, KHadijeh}, title = {Explaining the Challenges of the CCU Department in Non-Specialized Hospitals in Small Cities in the Face of the Covid-19 Pandemic: A Qualitative Study}, abstract ={Background & aim: The COVID-19 pandemic has affacted a challenge to all healthcare systems. Crises put a lot of pressure on healthcare staff, especially in small towns where hospitals are not specialized. Therefore, the present study aimed to explain the challenges of the CCU department in non-specialized hospitals in small towns in the face of the COVID-19 pandemic from the perspective of service providers. Methods: The present study is qualitative and of the conventional content analysis type. Participants were selected purposively. Semi-structured interviews were used to collect data, and the interview process continued until complete data saturation. The qualitative data analysis process was carried out based on the Granheim and Landman method. Results: In this study, from 326 open codes, ten subcategories and three themes were extracted, including: structural environmental changes (transformation of the CCU ward into a COVID ICU, transformation of the general ward (one room) into a CCU, lack of equipment and facilities in the CCU ward, and change in the method of programming nurses' shifts from monthly to daily), personnel challenges (doctors' dissatisfaction, nurses' dissatisfaction with the ward, dissatisfaction with the lack of attention to non-COVID nurses' services, nurses' dissatisfaction with the lack of experience and knowledge of working with ICU patients), and inadequate management of cardiovascular patients (loss of cardiac patients and problems of cardiac patients in the CCU alternative ward). Conclusion: This study showed that sudden changes in the structure and management of human resources in the CCU department led to various challenges in the field of services provided to cardiovascular patients. Therefore, it is necessary for health system officials to pay serious attention to examining and improving the working conditions of nurses and providing appropriate equipment and space for treating patients.}, Keywords = {COVID-19, Health Challenges, Nursing, Cardiac Patient Management, CCU}, volume = {17}, Number = {4}, pages = {9-18}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.4.9}, url = {http://jccnursing.com/article-1-805-en.html}, eprint = {http://jccnursing.com/article-1-805-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2025} } @article{ author = {Rezaei, Golestaneh and Salmani, Fatemeh and Hajsadegian, Mi}, title = {Investigating the Relationship between Death Anxiety and Perceived Social Support in CABG Patients Admitted to the Cardiac Intensive Care Unit: A Cross-Sectional Study}, abstract ={Background & aim: Coronary artery bypass grafting surgery is still known as the first and most important choice in the treatment of heart patients in some patients. Death anxiety is the most common psychological complication of patients who are candidates for coronary artery bypass grafting surgery, which can be affected by factors such as support from others and the community. The aim of the present study was to determine the relationship between death anxiety and perceived social support in CABG patients hospitalized in the cardiac intensive care unit. Methods: This study was conducted as a descriptive correlation. 100 CABG patients hospitalized in the cardiac intensive care unit referred to Shariati Hospital in Isfahan in 1402 were included in the study through convenience sampling. After receiving informed consent from the research units, the researcher explained to the patients how to complete the questionnaire. The data collection tool consisted of a questionnaire that included three parts: the first part was the demographic characteristics of the research samples, the Templer Death Anxiety Questionnaire, and the Perceived Social Support Scale questionnaire. Results: The study findings showed that the total score of death anxiety was moderate. And the total score of patients' perceived support was 68.4 ± 11.9, the social support score was 22.7 ± 4.1, family support was 23.2 ± 3.5, and the score of friends' support was 22.4 ± 4.6. And there is an inverse and significant relationship between perceived social support and death anxiety. Conclusion: The results of the present study indicate the importance of perceived social support in reducing death anxiety in these patients, therefore, it is necessary to take measures in line with support resources and pay attention to it and recognize the factors affecting it by nurses working in cardiac special wards, and it is recommended that this issue be included in the training for caring for these patients.}, Keywords = {Death Anxiety, Perceived Social Support, Coronary Artery Bypass Graft}, volume = {17}, Number = {4}, pages = {19-27}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.4.19}, url = {http://jccnursing.com/article-1-791-en.html}, eprint = {http://jccnursing.com/article-1-791-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2025} } @article{ author = {Ganji, Mohammad and Navab, Elham and Esmaeili, Maryam and haghani, Shima and Shali, Mahboubeh}, title = {Evaluation and Comparison of Diagnostic Accuracy of Early Warning Scores in Trauma Patients for Determining the Need for Intensive Care Unit Admission: A Prospective Study}, abstract ={Background & aim: Predicting the need for intensive care in patients requires predicting the level of risk. Determining the amount of risk that threatens patients can lead to making correct treatment decisions. The present study aimed to determine and compare the diagnostic accuracy of early warning scores in trauma patients to determine the need for intensive care unit admission. Methods: This prospective study was conducted from December 2024 to January 2025 in hospitals affiliated with Tehran University of Medical Sciences. Using the convenience sampling method, 250 trauma patients were enrolled in the study. To collect data, a demographic information questionnaire and warning scores of the National Early Warning Score 2, the Modified Early Warning Score, the Triage Early Warning Score, and the Modified Emergency Medicine Score were used. Results: The mean age of the patients was 40.90 ± 15.78. Accident (56.8%) was the most common mechanism of trauma and multiple trauma (56%) was the most common type of trauma. The National Early Warning Score 2 showed the highest diagnostic accuracy with sensitivity (82.2%), specificity (81.1%), and area under the curve (0.889). Conclusion: While all four early warning scores had good ability to detect ICU admission, there were significant differences in their performance measures. The higher diagnostic accuracy of the National Early Warning Score 2 makes it a valuable tool in identifying patients who may require ICU admission.}, Keywords = {Early Warning Score, Trauma Nursing, Intensive Care Units}, volume = {17}, Number = {4}, pages = {28-36}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.4.28}, url = {http://jccnursing.com/article-1-807-en.html}, eprint = {http://jccnursing.com/article-1-807-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2025} } @article{ author = {Samieipoor, Farkhondeh and Eydizadeh, Zahra and Akbari, Leil}, title = {Assessment of the Adherence to Infection Control Standards during the Insertion of Peripheral Venous Catheters: A Descriptive-Analytical Study}, abstract ={Background & aim: Standard precautions are designed to protect patients and hospital staff from potential exposure to contaminated blood and body fluids. This is possible by applying standard principles for infection prevention. In addition, bloodstream infections associated with peripheral venous catheters are a common problem in hospitalized patients. This study was conducted to determine the extent to which infection control standards are followed when inserting peripheral venous catheters. Method: This descriptive-analytical study was conducted using convenience sampling method on 86 nurses of surgical ward and Invasive Care Units (ICU) of Al-Zahraa subspecialty Hospital of Isfahan in 2024. The research tool was a researcher-made questionnaire including demographic characteristics and a checklist to check the level of compliance with standard precautions when inserting intravenous catheters. Results: The findings showed that the mean and standard deviation of the score of compliance with standard precautions was 83.56 ± 16. There was no significant relationship between age and experience in the ICU or surgery with the score of compliance with standard precautions during insertion of intravenous catheters in the studied units (P < 0.05). However, overall work experience had a direct relationship with compliance with standard precautions during the insertion of intravenous catheters (P < 0.001). Conclusion: According to the findings of this study, despite the fact that there was no relationship between the level of compliance with standard precautions and the age and work experience of personnel, the role of retraining courses in updating personnel information was insignificant, which requires further studies in order to improve the quality of standard precautions.}, Keywords = {Infection Control Standards, Catheter Insertion, Peripheral Vein}, volume = {17}, Number = {4}, pages = {37-46}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.4.37}, url = {http://jccnursing.com/article-1-800-en.html}, eprint = {http://jccnursing.com/article-1-800-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2025} } @article{ author = {Neichi, Sara and Vatandost, Salam and Nouri, Bijan and Valiee, Si}, title = {The Relationship between Family Satisfaction and Engagement in the Care of Intensive Care Units Patients: A Cross-Sectional Study}, abstract ={Background & aim: In today’s world, satisfaction is considered an important indicator in evaluating the quality-of-care services. Due to limitations such as low level of consciousness of patients in the Intensive Care Unit (ICU), family members play an important role in assessing satisfaction and participating in treatment decision making. As a result, the present study was conducted with the aim of investigating the level of satisfaction of family members and its relationship with their engagement in the care of patients hospitalized in ICUs. Methods: This cross-sectional study was conducted in 2023 with the participation of 70 family members of patients admitted to the ICU of Tohid Hospital in sanandaj, who were selected through convenience sampling. Data were collected through Family satisfaction questionnaire and Family engagement questionnaire and analyzed using Spearman, Mann-Whitney, and Kruskal-Wallis nonparametric statistical tests. Results: The mean age of the participants was reported as 39.54 ± 9.91 years. The overall mean satisfaction score was 70.58 ± 18.77, which was above the median score. The highest score was related to satisfaction with the care provided being 73.13 ± 18.06, while satisfaction with decision-making was 67% ± 22.34. Family members' engagement in patient care was measured at 76.76 ± 17.78. Spearman’s correlation test revealed a statistically significant relationship between overall satisfaction and its subscales with family engagement, indicating that higher engagement was associated with greater satisfaction. Conclusion: Given the direct and significant correlation between family members’ satisfaction and their engagement, it is recommended that appropriate interventions be designed and implemented to enhance family involvement in treatment process and clinical decision-making, thereby improving the quality-of-care services. Additionally, health system managers are encouraged to adopt specific policies that enable greater family engagement through nursing staff.}, Keywords = {Intensive Care Units, Nursing care, Family, Patient Satisfaction}, volume = {17}, Number = {4}, pages = {47-57}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.4.47}, url = {http://jccnursing.com/article-1-809-en.html}, eprint = {http://jccnursing.com/article-1-809-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2025} } @article{ author = {Salehinia, Jalal and Khajeaminian, Mohammad Reza and ZareReshkouie, Mohammad and Nasiriani, Khadijah}, title = {The Level of Compliance with National Standards in Resuscitation Trolleys in Teaching Hospitals in Yazd in 2024: A cross-Sectional Study}, abstract ={Background & aim: Effective and safe management of cardiopulmonary arrest in hospitals relies on immediate access to emergency drugs, equipment, and supplies. A resuscitation trolley is a set of drawers and shelves on wheels that are intended for transporting and distributing drugs and equipment in emergency situations. Periodic inspection and completion of the resuscitation trolley to comply with the standard is very important to ensure that the trolley is ready in emergency situations. The present study was conducted to determine the compliance of the resuscitation trolley with national standards in Yazd teaching hospitals in 1403. Methods: This study was a cross-sectional research. The study samples included 71 emergency trolleys in hospital wards. The researcher randomly visited all departments of university teaching hospitals in Yazd city in different shifts and evaluated the quality and quantity of medicines, consumables and equipment of the trolleys with a checklist compiled based on the latest standard guidelines for resuscitation trolleys. Results: According to findings, in terms of compliance with the national guidelines, medicines were not available in the first drawer 11.27% and the second drawer 19.72%, and the equipment in the third drawer 14.09%, the fourth drawer 40.84% and the fifth drawer 37.62%. In terms of the number of medicines in the first drawer 52.11%, the second drawer 66.20% and the equipment in the third drawer 25.59%, the fourth drawer 20.32% and the fifth drawer 43.26% were insufficient. In terms of the expiration date of the drugs in the first drawer 11.27% and the second drawer 19.72% and the expiration date of the equipment and devices in the third drawer 14.56%, the fourth drawer 23.74% and the fifth drawer 39.83% were not valid. Also, in terms of the presence and readiness of the oxygen capsule or central oxygen system 12.7% and 29.8%, suction 29.6% and 45.1%, defibrillator 8.5% and 8.5%, external pad 47.9%, the response was negative. The quality of the trolley was examined with 24 items, and in most cases, structural or quality problems were not found in the resuscitation trolleys. Conclusion: In comparing the resuscitation trolleys with the national standard, it can be concluded that the resuscitation trolleys are acceptable but are not maintained completely in accordance with the latest national guidelines. Therefore, in order to follow the latest resuscitation trolley guidelines, measures such as developing and reviewing the policy for periodic control of resuscitation trolleys and replacing drugs and devices, reviewing the resuscitation trolley standard based on the treatment department, and training staff on the latest resuscitation trolley guidelines are being implemented.}, Keywords = {Resuscitation Trolley, Emergency Trolley, Emergency Drugs, Emergency Equipment, Airway Managemen}, volume = {17}, Number = {4}, pages = {58-65}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.4.58}, url = {http://jccnursing.com/article-1-808-en.html}, eprint = {http://jccnursing.com/article-1-808-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2025} } @article{ author = {Arabfard, Masoud and Maher-Sultan, Hosny and vahedian-azimi, Amir}, title = {AI Taxonomy and Statistical Paradigms in Intensive Care: Transforming Diagnosis, Management, and Outcomes: Invited Review Paper}, abstract ={Background & aim: The intensive care unit (ICU) is among the most critical hospital departments, requiring rapid and precise decision-making based on vast amounts of data. Artificial intelligence (AI), by providing advanced analytical tools, is playing an increasingly prominent role in enhancing diagnostic, therapeutic, and management processes in this setting. The primary aim of this review article is to present a systematic classification of different types of AI and their associated statistical methods, with a focus on their applications in critical care. This classification is intended to facilitate a clearer and more practical understanding of these technologies within the ICU. Methods: This narrative review was designed and conducted in accordance with established standards for narrative review articles. The research process was structured into four main phases. First, a comprehensive literature search was performed across major scientific databases, including PubMed, Scopus, Web of Science, and IEEE Xplore. The search strategy employed a combination of keywords related to artificial intelligence, intensive care, machine learning, early diagnosis, and resource management in critical care, along with their English equivalents. The search was limited to articles published between 2010 and 2024. In the second phase, clear inclusion and exclusion criteria were established. Cohort studies, clinical trials, meta-analyses, and review articles focusing on the application of artificial intelligence in intensive care were included. Animal studies, non-systematic case reports, and articles without full-text availability were excluded. During the data extraction and analysis phase, key information from each study was collected, including the type of artificial intelligence approach (symbolic AI, machine learning, deep learning, fuzzy systems), the specific models used (neural networks, support vector machines, decision trees), the domain of application (diagnosis, risk prediction, treatment management), and measures of effectiveness (accuracy, sensitivity, improvement in clinical outcomes). The final phase involved the development of an analytical framework based on two main axes: first, the classification of AI approaches by capability, distinguishing between rule-based systems (symbolic AI) and data-driven systems (deep learning); and second, a performance-based classification encompassing diagnostic applications (such as radiological image analysis), predictive modeling (risk models), and decision-making (optimization of treatment protocols). Specialized models were further evaluated for their practical utility in intensive care settings, including the use of convolutional neural networks for physiological data analysis and fuzzy systems for resource management. Ultimately, the findings were organized in a comparative matrix structured by model type, domain of application, and level of supporting evidence. Interdisciplinary overlaps, such as the integration of reinforcement learning with clinical decision support systems, were also identified. This methodology was developed in accordance with best practices for narrative reviews, emphasizing transparency and rigor in reporting. Results: The results of this review indicate that AI in critical care encompasses a wide range of approaches, including symbolic AI, machine learning (supervised, unsupervised, and reinforcement learning), deep learning, evolutionary AI, fuzzy systems, and swarm intelligence. Each of these approaches, utilizing specific statistical methods, offers unique capabilities in areas such as early disease detection, risk prediction, treatment optimization, and resource management. Conclusion: While the proposed classification can enhance understanding of AI applications in critical care, it is important to note that these categories are not always mutually exclusive, and there is overlap between different approaches. The choice of the appropriate AI method and corresponding statistical technique depends on the specific characteristics of the problem and the available data. Nevertheless, a thorough understanding of AI types and their statistical foundations enables critical care professionals to take effective steps toward improving care quality and patient outcomes. The intersection of AI and critical care opens new horizons for advancing patient health and improving therapeutic results. AI, with its broad spectrum of approaches and techniques, holds transformative potential for critical care. Deep knowledge of these methods empowers specialists to select optimal strategies for improving patient health. The integration of AI and critical care is set to reshape the future of medicine. Responsible development requires attention to ethical challenges and ensuring equitable use of these technologies.}, Keywords = {Artificial Intelligence, Specialized Models, Critical Care, Diagnosis, Care, Treatment}, volume = {17}, Number = {4}, pages = {66-80}, publisher = {دانشگاه علوم پزشکی بقیه الله (عج)}, doi = {10.30491/JCC.17.4.66}, url = {http://jccnursing.com/article-1-811-en.html}, eprint = {http://jccnursing.com/article-1-811-en.pdf}, journal = {Journal of Critical Care Nursing}, issn = {2008-336X}, eissn = {2008-3084}, year = {2025} }