Palliative care is the science of promoting the patient's quality of life. It can improve the quality of life of a patient, which is effective not only in patient's late-life but also useful in dealing with a chronic illness over many years. In this regard, nurses, as the largest providers of health care services, play an important role in palliative care.Objective: This study aimed to investigate the palliative care knowledge of nurses and its contributing factors. Materials and Methods:This cross-sectional study was conducted on 280 nurses working in different departments of hospitals affiliated to Guilan University of Medical Sciences (GUMS). They were recruited using the stratified random sampling technique. Their data were collected by a demographic form and the Palliative Care Quiz for Nursing (PCQN) instrument. The collected data were analyzed by Kruskal-Wallis and Mann-Whitney U tests. Results:The Mean±SD score of palliative care knowledge of study nurses was reported as 7.86±2.16 indicating their imperfect knowledge. Among studied factors, only the personal study about palliative care had a significant association with the nurses' knowledge (P=0.038). Conclusion:Nurses had poor knowledge of palliative care and its subscales that is one of the main obstacles in providing optimal palliative care. So, increasing their quality of palliative care services by improving their knowledge through in-service education and on the job retraining could promote the quality of palliative care services for the patients.

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Medication errors are one of the most common types of medical errors. In Intensive Care Units, because of its special circumstances, the risk of such errors is increasing. There are several causes for the medication errors of nurses, including environmental factors. Objective: The current study aimed at determining environmental factors contributing to medication errors based on the perceptions of ICU nurses. Materials and Methods: The current analytical cross-sectional study was conducted on 281 nurses working in special care units ICU of hospitals affiliated to Guilan University of Medical Sciences in 2014. Nurses' perspectives of environmental factors were investigated using a two-part researcher-designed questionnaire. The collected data were analyzed using Exploratory Factor Analysis (EFA). Results: Two factors with a predictive power of 68.32% remained as the most important environmental factors. The first factor explained 36.47% of the total variance of medication errors and the second factor explained 31.84%. The first factor consisted of three variables of "poor lighting", "high noise levels", and "inappropriate room temperature", while the second factor included the variables of "high number of patients", "lack of equipment for injection and drop-rate setting", and "inadequate space for medication preparation". Among these variables, poor lighting with a factor loading of 0.89 was reported as the most important environmental factor contributing to medication errors. Conclusion: Since poor lighting, high noise levels, and inappropriate room temperature were determined as the most contributing environmental factors to medication errors, it is recommended that managers and authorities of hospitals prevent and mitigate medication errors and improve patient's safety by modifying environmental conditions.

Acute myocardial infraction (AMI) is a highly frequent cause of mortality and disability around the world. The aim of the present study was to evaluate the associations between meat group intake levels and AMI risks in an adult Iranian population. This case-control study was conducted on 200 first AMI cases and 200 healthy individuals matched by age, sex, and body mass index. A Food Frequency Questionnaire validated for Iranian populations was used to assess usual dietary intake levels over the previous year. Data was extracted regarding the meat group—including meat (red and processed), fish, poultry, eggs, nuts, and legumes. The associations between meat group items and AMI were calculated by multivariable logistic regression. Red meat consumption was significantly positively associated with increased risk of AMI. After adjustment for potential confounders, a positive association was found between higher frequency of processed and red meat intake, and increased risk of AMI (processed meat consumption: odds ratio [OR], 1.71; 95% confidence interval [CI], 1.31–2.23 and red meat consumption: OR, 2.51; 95% CI, 1.84–5.11). In addition, the results indicated an inverse association between the frequency of nuts consumption and AMI (OR, 0.52; 95% CI, 0.31–0.92). There were no associations seen between poultry, fish, eggs and beans intake levels, and the odds of AMI. The current study suggested a direct association between the frequency of processed/red meat consumption and increased AMI risks. In addition, an inverse relation was observed between frequency of nuts consumption and the risks of AMI.

Nurses, as a large part of the healthcare team, are among the first to manage post-accident injuries. Thus, their readiness to cope with disasters is essential.

Background:Accumulation of secretions in the airways of patients with an endotracheal tube and mechanical ventilation will have serious consequences. One of the most common methods of airway clearance is endotracheal suctioning. In order to facilitate discharge of airway secretion resulting in promotion of gas exchange, chest physiotherapy techniques can be used at the time of expiration before suction.Materials and Methods:In this clinical trial with a cross-over design, 50 mechanically ventilated patients admitted to intensive care units (ICUs) were randomly divided into two groups of thoracic squeezing. In each patient, two interventions of endotracheal suctioning were conducted, one with and the other without thoracic squeezing during exhalation, with a 3 h gap between the two interventions and an elapse of three respiratory cycles between the number of compressions. Sputum secreted was collected in a container connected to a suction catheter and weighed. Data were recorded in data gathering forms and analyzed using descriptive and inferential statistics (Wilcoxon and independent t-test, Chi-square) in SPSS version 16.Results:Findings showed that the mean weight of the suction secretions removed from airway without thoracic squeezing was 1.35 g and that of suction secretions removed by thoracic squeezing was 1.94 g. Wilcoxon test showed a significant difference regarding the rate of secretion between the two techniques (P = 0.003).Conclusions:According to the study findings, endotracheal suction with thoracic squeezing on expiration helps airway secretion discharge more than suction alone in patients on mechanical ventilators and can be used as an effective method.

Background: Protein-energy malnutrition, one of the most important risk factors for cardiovascular diseases, is common in dialysis patients. In this way, several characteristics and socio-economic factors could influence nutritional stats. The diagnosis of malnutrition and its related factors can assist the healthcare team in planning for the care of hemodialysis patients. Objectives:In this study, we are aimed to determine the nutritional status among hemodialysis patients and characteristics and also socio-economic factors. Methods:In this cross-sectional study, 312 patients were selected randomly. Modified subjective global assessment (SGA) tool was used for data collection. The data was expressed as mean ± SD and frequency. Logistic regression analysis was performed to detect predicting factors of malnutrition using SPSS software.Results: About 65.1% of hemodialysis patients suffered from mild-to-moderate malnutrition and 15% of patients were severely malnourished. Most patients were married (82.7%), low-income (63.1%), illiterate (63.8%) and employed (52.2 percent). Following the subgroup analysis, we found significant weight changes in malnourished patients (P value = 0.000). In addition, we found that severely malnourished patients were older, married or divorced, unemployed and lived in large families compared with other groups (P value < 0.05). The illiterate people were in greater risk for malnutrition (AOR = 8.14, 95% CI: 1.8 -36.89). Conclusions:Socio-economic factors such as income, education, living conditions, marital status, family size and employment affect nutritional status. Therefore, taking socio-economic factors into account can help the treatment team in the care of hemodialysis patients.

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