@article{ 
author = {Shahmohammadi, Fatemeh and Eghbali, Maryam and Shirani, Farimah and MirmohammadSadeghi, Mohse},  
title = {Using Mobile Phone Applications in Clinical Nursing Education for Care in the Open Heart Surgery ICUs}, 
abstract ={Background & aim: The use of applications for the purposes of medical care education has been of interest in recent years. However, there is no effective application for training personnel in the area of open heart post-operative care. Therefore, the present study was conducted in order to design and evaluate an educational application for open heart post-operative care for nurses working in the Intensive Care Units (ICUs) of Isfahan Medical Sciences Hospital. Methods: This research was an applied research and technology development study conducted in 2024. The research population consisted of all nurses working in the ICUs of hospitals affiliated to Isfahan University of Medical Sciences who met the inclusion criteria. Sampling was performed using the census method. The smartphone-based application evaluation questionnaire, developed by Faradmal, was used. This study was conducted in four stages: assessment and analysis of user needs, design and preparation of educational content based on validated scientific texts and opinions of relevant professors, design of a smartphone-based application, implementation and evaluation of the application. The needs assessment was conducted in two groups, including nurses working in the ICUs of Chamran Hospital, with a sample size of 30 subjects and an expert panel of 10 individuals. After using the application for two weeks to one month, the application evaluation questionnaire was completed online by 52 nurses.  For data analysis, descriptive statistical methods were used to determine the mean score of the application in terms of usability in the dimensions of screen, terms and system information, learning, system capabilities, satisfaction, ease of learning, and ease of use. Results: The results of the needs assessment from the perspective of nurses and experts showed that hemodynamic monitoring and related care with a mean of 3.79 ± 1.30 was the highest priority, while the lowest priority with a mean of 2.80 ± 1.59 belonged to nursing registration in cardiac surgery ICU. The assessment of the smartphone-based care program for open heart surgery patients showed that ease of use and ease of learning were the most highly rated by users. The number, percentage, and total score of the ratings were divided into four categories of excellent, good, average, and poor. Conclusion: The results of the application evaluation indicated that developing an educational application for open heart postoperative care for nurses based on their educational needs can improve the skills of nurses and provide better quality care. Most nurses reported being satisfied with the mobile application. Therefore, based on these findings, the use of applications is suggested for nurses working in ICUs.},  
Keywords = {Nurses, Application, Smartphone-Based Application, Open Heart Surgery},
volume = {18},
Number = {1}, 
pages = {1-10}, 
publisher = {دانشگاه علوم پزشکی بقیه الله (عج)},

doi = {10.30491/JCC.18.1.1},
url = {http://jccnursing.com/article-1-788-en.html},  
eprint = {http://jccnursing.com/article-1-788-en.pdf},  
journal = {Journal of Critical Care Nursing},  
issn = {2008-336X}, 
eissn = {2008-3084}, 
year = {2025}  
}

@article{ 
author = {Borhanzehi, Sohila and Mazarzaei, Sayimeh and DehghanMehr, Sadegh},  
title = {Studying the Effect of the Care Bundle Approach on Nosocomial Infections in Intensive Care Unit Patients: A Scoping Review}, 
abstract ={Background & aim: Hospital-Acquired Infections (HAIs) are a persistent concern and occur more frequently in Intensive Care Units (ICUs). Evidence indicates that the use of care bundles can prevent HAIs and their associated complications. Therefore, this scoping review aimed to evaluate the impact of care-bundle approaches on HAIs among critically ill patients in the ICU. Methods: This domain-focused scoping review assessed the effect of ICU care bundles on the prevention of HAIs employing the five-step Arksey & O'Malley framework. After formulating the research question, relevant articles were searched in Web of Science, PubMed, Google Scholar, and SID. Studies were imported into the RAYYAN software, and investigators independently screened titles and abstracts against predefined inclusion criteria. In total, 355 studies were identified. Results: Of these, 23 studies met the inclusion criteria. Among them, 15 evaluated the impact of care bundles on prevention of ventilator-associated pneumonia (VAP), three assessed bundles for prevention of Catheter-Related Bloodstream Infections (CRBSIs), three related to prevention of catheter-associated urinary tract infections (CAUTIs), one addressed prevention of Surgical Site Infections (SSIs), and one study examined three bundles addressing VAP, CAUTI, and CRBSI. The majority of studies reported a positive effect of care bundles on preventing HAIs in ICU settings. Conclusion: Findings from this review indicate that bundle-based approaches are effective in preventing HAIs in ICU patients. Key factors associated with success include strict adherence to hand hygiene, faithful implementation and monitoring of care bundles, ongoing nurse education, and teamwork, which collectively contribute to reductions in HAIs, shorter hospital stays, and lower healthcare costs.},  
Keywords = {Care Bundles, Intensive Care Unit, Nosocomial Infection},
volume = {18},
Number = {1}, 
pages = {11-22}, 
publisher = {دانشگاه علوم پزشکی بقیه الله (عج)},

doi = {10.30491/JCC.18.1.11},
url = {http://jccnursing.com/article-1-797-en.html},  
eprint = {http://jccnursing.com/article-1-797-en.pdf},  
journal = {Journal of Critical Care Nursing},  
issn = {2008-336X}, 
eissn = {2008-3084}, 
year = {2025}  
}

@article{ 
author = {Nasiryani, KHadijeh and Azizadini, Seyed Shahabadin and Zamani, Najme and Salmani, Ebrahim and Fazljoo, Seyede Elham},  
title = {Explaining the Impact of the COVID-19 Pandemic on the Angiography Sector from the Perspective of Healthcare Workers: A Qualitative Study}, 
abstract ={Background & aim: The Covid-19 pandemic has faced the world with a crisis in the health system, and the angiography sector has not been spared from these effects. Understanding the experiences and perceptions of staff in the angiography department aims to uncover and analyze the experiences, challenges, adapted strategies, and organizational implications in the angiography department during the pandemic to provide a deep understanding of the factors facilitating or limiting the provision of safe and efficient services in the face of future health crises. The present study aimed to explain the impact of the COVID-19 pandemic on the angiography department from the perspective of healthcare system staff. Methods: The current study was a qualitative type of contractual content analysis. Participants were purposively selected from cardiologists and other staff of the angiography department of Shahid Sadoughi Hospital in Yazd. Data collection was conducted through eight semi-structured interviews until saturation was achieved. The average duration of each interview was approximately 28 minutes. Qualitative data analysis was performed based on the method proposed by Granheim and Landman using MAXQDA software version 2018. Results: Based on the qualitative analysis of the data, from the challenges created during the Covid-19 pandemic in the angiography department, seven subcategories and two main themes were extracted. The main theme of employee transformation, including the subclasses feeling of inconsistency in the appreciation of nursing services, less provision of protective equipment, dissatisfaction with the sudden change in the workplace and the main theme of patients and the path of change, including the subclasses, was the reduction of patients' visits for angiography, the complication of the hospitalization process for angiography, the change of the angiography process of Covid-19 patients and the increase in compliance with health protocols. Conclusion: This study, with in-depth qualitative analysis, showed that Covid-19 occurred with changes in the angiography department both internally and in human experiences (staff and patients). Furthermore, it significantly affected internal processes and interactions. Therefore, it is recommended that healthcare centers prepare for future crises based on evidence and experiences from the Covid-19 pandemic.},  
Keywords = {Covid-19, Angiography, Health Workers, Challenges, Experiences.},
volume = {18},
Number = {1}, 
pages = {23-32}, 
publisher = {دانشگاه علوم پزشکی بقیه الله (عج)},

doi = {10.30491/JCC.18.1.23},
url = {http://jccnursing.com/article-1-813-en.html},  
eprint = {http://jccnursing.com/article-1-813-en.pdf},  
journal = {Journal of Critical Care Nursing},  
issn = {2008-336X}, 
eissn = {2008-3084}, 
year = {2025}  
}

@article{ 
author = {Sadoughi, Fatemeh and Shareinia, Habib and SadeghMoghadamAbbaspour, Leila and Gholamzadeh, Maliheh and Mansoorian, Mohammadrez},  
title = {The Effect of Structured Hope-Based Training on Hope and Anxiety among Family Members of Mechanically Ventilated Patients: 
A Semi- Experimental Study}, 
abstract ={Background & aim: Anxiety is one of the most common responses among family members of patients admitted to Intensive Care Units (ICUs), affecting their ability to provide support. Hope, as a key coping resource, can play an effective role in reducing anxiety. Accordingly, the present study aimed to investigate the effect of structured hope-building training on hope and anxiety among relatives of patients undergoing mechanical ventilation. Methods: In this semi-experimental study, 60 family members of patients admitted to the ICU were selected using convenience sampling and assigned to intervention and control groups. The intervention group received structured hope-building training based on Snyder’s Hope Therapy protocol, delivered face-to-face in groups of 6–12 participants, for 60–90 minutes per session, every other day over the course of one week. Data were collected using demographic questionnaires, the Spielberger State Anxiety Inventory, and the Miller Hope Scale, administered once before the intervention and once one week after. Data were analyzed using SPSS version 20 with paired t-tests and independent t-tests. Results: Paired t-test results indicated that in the intervention group, both state and trait anxiety significantly decreased, while hope significantly increased (P<0.001). In the control group, significant reductions in state and trait anxiety were also observed, accompanied by a decrease in hope (P<0.001). Independent t-test results showed that the mean trait anxiety in the intervention group (41.33 ± 8.34) was significantly lower than in the control group (47.58 ± 8.27; P = 0.004). The mean hope score in the intervention group (112.25 ± 25.25) was significantly higher than in the control group (95.93 ± 25.96; P = 0.016). No significant difference in state anxiety was observed between the two groups (P = 0.405). Conclusion: Structured hope-based training led to a reduction in anxiety and an increase in hope among relatives of patients undergoing mechanical ventilation, and it may be considered as a complementary approach in nursing care.},  
Keywords = {Education, Hope, Anxiety, Relatives, Mechanical Ventilation},
volume = {18},
Number = {1}, 
pages = {33-42}, 
publisher = {دانشگاه علوم پزشکی بقیه الله (عج)},

doi = {10.30491/JCC.18.1.33},
url = {http://jccnursing.com/article-1-823-en.html},  
eprint = {http://jccnursing.com/article-1-823-en.pdf},  
journal = {Journal of Critical Care Nursing},  
issn = {2008-336X}, 
eissn = {2008-3084}, 
year = {2025}  
}

@article{ 
author = {Alipoor, Mina and Khodabandeh, Sedigheh and Tajadini, Maryam and ShakeriGoki, Mohamad Hossie},  
title = {The Role of Artificial Intelligence in Enhancing Patient Safety: Perspectives and Challenges in the Operating Room: A Scoping Review}, 
abstract ={Background & aim: The operating room is one of the most critical environments in healthcare, where even minor errors can have severe consequences for patients. Artificial Intelligence (AI) has emerged as an innovative tool for enhancing patient safety by reducing medical errors and improving surgical outcomes. This review explores the role of AI in increasing patient safety in the operating room. Methods: This study was a scoping review based on the Arksey and O’Malley framework, incorporating modifications. A systematic search of relevant literature was conducted in databases such as PubMed, Scopus, and Web of Science, with predefined inclusion and exclusion criteria. Results: Findings indicate that AI contributes to patient safety by minimizing surgical errors, improving clinical decision-making, reducing surgical team fatigue, preventing retained surgical instruments, and managing medical errors. AI-driven technologies, such as machine learning, computer vision, and robotic-assisted surgery, enhance procedural accuracy and decision-making efficiency. Conclusion: AI holds significant potential in improving patient safety in surgery. However, widespread adoption requires robust infrastructure, clear regulatory guidelines, and targeted training for healthcare professionals to address existing challenges.},  
Keywords = {Artificial Intelligence, Patient Safety, Surgery, Operating Room, Medical Errors},
volume = {18},
Number = {1}, 
pages = {43-52}, 
publisher = {دانشگاه علوم پزشکی بقیه الله (عج)},

doi = {10.30491/JCC.18.1.43},
url = {http://jccnursing.com/article-1-826-en.html},  
eprint = {http://jccnursing.com/article-1-826-en.pdf},  
journal = {Journal of Critical Care Nursing},  
issn = {2008-336X}, 
eissn = {2008-3084}, 
year = {2025}  
}

@article{ 
author = {Khalili, Zahra and Cheraghi, Fatemeh and Oshvandi, Khodayar and Borzou, Seyed Rez},  
title = {The Application of Roy\'s Adaptation Model in the Care of a Patient with Mechanical Valve: A Case Study}, 
abstract ={Background & aim: Patients with mechanical heart valves are required to receive lifelong anticoagulation. To standardize care, nurses can use nursing models to increase patient compliance. The aim of this study was to apply the Roy adaptation model to the care of a patient with a mechanical heart valve. Methods: This case study was conducted with the participation of a patient with a mechanical heart valve hospitalized at Farshchian Heart Hospital in Hamadan for three months in 2024. Data were collected using observation, interview, and patient file documentation and were examined in four dimensions based on the stages of the Roy nursing process. Results: The results showed that the patient had maladaptive behaviors in physiological dimensions, self-perception, role performance, independence, and dependence, and that after providing nursing care based on the Roy adaptation model, the patient's adaptive behaviors increased. Conclusion: Implementing a nursing care program based on the adaptation model can be effective in patients' adaptation to mechanical heart valve replacement. Accordingly, the use of this model is recommended for nurses.},  
Keywords = {Nursing Model, Patients, Nursing Process},
volume = {18},
Number = {1}, 
pages = {53-58}, 
publisher = {دانشگاه علوم پزشکی بقیه الله (عج)},

doi = {10.30491/JCC.18.1.53},
url = {http://jccnursing.com/article-1-821-en.html},  
eprint = {http://jccnursing.com/article-1-821-en.pdf},  
journal = {Journal of Critical Care Nursing},  
issn = {2008-336X}, 
eissn = {2008-3084}, 
year = {2025}  
}

@article{ 
author = {Abedin, Maedeh and Aboutalebi, 4-	Mohammad sadegh and Tarrahi, Mohammad Javad and Ghaffari, Somayeh},  
title = {The Investigation and Comparison of Two Tools, Wells and Caprini, in Predicting the Occurrence of Venous Thromboembolism in Patients Hospitalized in Critical Care Units: A Cross Sectional Study}, 
abstract ={Background & aim: Today, Wells criteria are most often used to assess the risk of venous thromboembolism in the clinic, but there are other methods to assess this risk, one of which is the Caprini criteria. Considering the importance of the role and position of nursing in assessing the risk of venous thromboembolism, and the need to use different criteria to predict the likelihood of venous thromboembolism, and due to the lack of studies on the clinical comparison of these criteria, the present study aimed to investigate and compare the two criteria of Wells and Caprini in the incidence of venous thromboembolism. Methods: This study was a retrospective cross-sectional descriptive study that was conducted on 420 patients hospitalized in affiliated to the Isfahan University of Medical Sciences. Convenience sampling was conducted in such a way that, based on the inclusion criteria, the sampling continued until the desired sample size was reached. Inclusion criteria included a definitive diagnosis of venous thromboembolism by a physician based on history, physical examination, and two gold standards of embolism protocol CT scan and Doppler ultrasound, and age over 18 years. Data collection was done using Information forms designed by the researcher according to the variables information forms. The researcher, referring to the patient's file, calculated and measured the two criteria of Wells and Caprini of the patient in the Intensive Care Unit and finally examined the sensitivity and specificity of these two criteria in predicting the incidence of venous thromboembolism during the hospitalization of patients in order to achieve a more accurate criterion for determining and predicting venous thromboembolism in patients. Data analysis was performed using the t-test and chi-square test. Quantitative data were presented as mean standard deviation, and qualitative data were presented as frequency and percentage. To evaluate and compare the best sensitivity and specificity, the relevant formulas and ROC curves were used. McNemar’s test was applied to compare sensitivity and specificity. Results: A total of 420 patient records were reviewed, of which 247 patients had venous thromboembolism and 173 patients did not. The samples were divided into two groups based on disease status, and the variables of interest were extracted and compared between the two groups. Based on the independent t-test, there was no significant difference between the two groups in terms of mean age, mean Body Mass Index (BMI), and mean number of days hospitalized before ICU admission. However, there were significant differences in other demographic variables such as gender (P=0.035), reason for hospitalization (P=0.002), and mobility status (P<0.001). There was no statistically significant difference in the sensitivity and specificity of the Wells and Caprini tools for predicting VTE occurrence. That is, based on the statistical analysis, the difference in the diagnostic accuracy between these two tools was so small that cannot be considered a true or reliable difference. Conclusion: Comparing these tools can help address numerous challenges in clinical practice, such as selecting the appropriate model for a specific type of patient or situation. In other words, the comparison can reveal which subgroups (e.g., internal medicine, surgical, or emergency patients) each model performs better for. Another challenge may be the predictive accuracy of the tool; one of the main concerns in predictive models is the ability to distinguish high-risk patients from low-risk ones. By comparing the two models, it is possible to determine which model has better sensitivity in the target population. Such a comparison can simplify clinical application, as models with numerous parameters or difficult-to-measure variables may have limited practical use. Both the Wells and the Caprini tools perform similarly in the diagnosis and prediction of venous thromboembolism, and no statistically significant difference in their diagnostic accuracy was observed. This issue can be used in clinical decision-making to select the appropriate tool, based on other criteria (such as ease of use, cost, or time required for assessment).},  
Keywords = {Wells Criteria, Caprini Criteria, Venous Thromboembolism, Intensive Care Units},
volume = {18},
Number = {1}, 
pages = {59-66}, 
publisher = {دانشگاه علوم پزشکی بقیه الله (عج)},

doi = {10.30491/JCC.18.1.59},
url = {http://jccnursing.com/article-1-815-en.html},  
eprint = {http://jccnursing.com/article-1-815-en.pdf},  
journal = {Journal of Critical Care Nursing},  
issn = {2008-336X}, 
eissn = {2008-3084}, 
year = {2025}  
}

@article{ 
author = {BastanPira, Maryam and GhanbariZarandi, Zahra and Kikha, Alireza and MohammadiSoleimani, Mohammadreza and Ali-Soufi, Elah-Nazar and Sanjari, Shahrz},  
title = {Validation of the Academic Self-Regulation Scale in a Blended Learning Environment: A Cross Sectional Study}, 
abstract ={Background and aim: With the expansion of blended learning in medical education and the Ministry of Health’s requirement to conduct some classes virtually, academic self-regulation skills have gained increasing importance. This study aimed to examine the factor structure and reliability of the Academic Self-Regulation Questionnaire among nursing and midwifery students in southeastern Iran. Method: This cross-sectional descriptive study with a psychometric approach was conducted during the 2024–2025 academic year. The target population consisted of nursing and midwifery students from the universities of medical sciences in Kerman and Sistan and Baluchestan provinces. A total of 1,040 students were included in four groups: 150 for concurrent validity, 500 for exploratory factor analysis, 250 for confirmatory factor analysis, and 150 for test–retest reliability. The main instrument was the Academic Self-Regulation Questionnaire by Akhtar, and for concurrent validity, the Gomez self-regulation questionnaire was used. The questionnaire was culturally adapted using forward–backward translation, and content validity, construct validity, concurrent validity, Cronbach’s alpha, and test–retest reliability were confirmed. Statistical analyses included Pearson correlation, exploratory and confirmatory factor analyses, Cronbach’s alpha, Spearman–Brown coefficient, and test–retest reliability. Results: Content validity was confirmed by experts, with the Content Validity Ratio ranging from 0.80 to 1.0 and the Content Validity Index between 0.83 and 0.93. Exploratory factor analysis extracted five main factors, explaining 61.33% of the total variance. Confirmatory factor analysis indicated good fit for the five-factor model. The correlation between the Academic Self-Regulation Questionnaire and Gomez’s questionnaire was 0.76, demonstrating acceptable concurrent validity (P<0.01). Cronbach’s alpha for the total scale was 0.92 and ranged from 0.81 to 0.93 across dimensions. Additionally, both the Spearman–Brown coefficient and test–retest reliability was satisfactory (≥0.70), indicating stable reliability. Conclusion: The validated Academic Self-Regulation Scale demonstrates a stable factor structure and satisfactory reliability among nursing and midwifery students in southeastern Iran, and it is recommended for assessing academic self-regulation in blended learning environments.},  
Keywords = {Self-regulation, Students, Factor analysis, Questionnaire, Iran},
volume = {18},
Number = {1}, 
pages = {67-77}, 
publisher = {دانشگاه علوم پزشکی بقیه الله (عج)},

doi = {10.30491/JCC.18.1.67},
url = {http://jccnursing.com/article-1-816-en.html},  
eprint = {http://jccnursing.com/article-1-816-en.pdf},  
journal = {Journal of Critical Care Nursing},  
issn = {2008-336X}, 
eissn = {2008-3084}, 
year = {2025}  
}