Few studies, especially among developing countries such as Iran, have been conducted on the incidence and risk factors for medical device‐related pressure ulcers (MDRPUs). Given the importance of this issue and the lack of previous studies, the present study aimed to investigate the incidence and risk factors for MDRPUs in Iran. The present descriptive‐analytical study was conducted at three hospitals in Qazvin, Iran, from June 1, 2019, to September 1, 2019. Data collection took approximately 3 months from July to September 2019. Sampling was carried out through a convenience sampling method, and the samples consisted of 404 patients. For data collection, a checklist for demographic variables, a checklist for patient‐connected medical devices, Braden Scale, Glasgow Coma Scale, National Pressure Ulcer Advisory Panel Pressure Grading Scale, and Nutrition Risk Screening 2002 were used. Of the 404 patients studied, 20.54% (n = 83) developed some degree of MDRPUs. From those, 61 (70.11%) were in stage I, 17 (19.5%) were in stage II, and 9 (10.34%) were in stage III. Among the nine medical devices that caused pressure ulcers, the most commonly reported ones were nasal oxygen tubes (31 cases), oxygen face masks (23 cases), and endotracheal tubes (17 cases). The mean score of Braden Scale (P = .004), the mean score of NRS 2002 (P = .037), older age (P = .007), male gender (P = .002), the average length of stay in hospitals (P = .001), and having pressure ulcers in body (P = .025) significantly increased the possibility of occurring MDRPUs. In the present study, the incidence of MDRPUs was high. Taking the necessary measures into consideration in order to prevent the MDRPUs is essential in Iranian hospitals. Further studies in this regard are strongly recommended.

Aim. To develop an instrument for the assessment of safe nursing care (ASNC) within the Iranian context and psychometrically evaluate its reliability and validity.Background. There is a need for a valid and reliable instrument to assess how nurses employ the components of safe nursing care in clinical practice in non-Western countries.Methods. This methodological study was conducted in two phases: (a) a qualitative phase of instrument development, and (b) a quantitative phase of psychometric evaluation of the Assessment of Safe Nursing Care (ASNC). The instrument's content validity was assessed by experts in the field of safe nursing care. The reliability of this instrument was examined by using internal consistency reliability and intra-rater reliability analysis. Exploratory factor analysis was then conducted to establish the instrument's initial construct validity.Results. The instrument developed was a questionnaire with 32 items. The Cronbach's alpha of the scale was 0.92 and Intra-class Correlation Coefficient for intra-rater reliability was 0.78.Exploratory factor analysis resulted in a four-factor solution: (a) nursing skills, (b) assessing the patient's psychological needs, (c) assessing the patient's physical need, and (d) nurses' teamwork. The four factors accounted for 63.54% of the observed variance. Conclusion.The ASNC can be applied to a wide variety of settings due to the broad range of methods utilized to generate items and domains, its comprehensive consideration of the principles of safe care, and its initial reliability and validity.Implications for Nursing Management. The ASNC can help nurse managers assess whether clinical nurses are prepared to apply their safe care skills in clinical practice. It can also be used by clinical nurses to assess their own and peers' practice to detect potential areas for improvement in nursing care and help nurse managers with planning appropriate quality improvement programs.

Objective:Cancer is considered a global health problem and its prevalence has been growing in recent years. The present study was conducted to investigate the role of hopelessness and perceived social support for Iranian patients with cancer.Methods:Convenience sampling was used to select the study sample comprising 100 patients with cancer presenting to the Education and Treatment Center of Valiasr in Zanjan, Iran. A demographic questionnaire, the Beck Hopelessness Scale, and the Social Support from Family and Friends Scale were used to collect the data. Collected data were analyzed using SPSS-16.Results:Of the 98 study patients, 52 (53.1%) were female and the remainder were male. Lung cancer constituted the most prevalent type of cancer (25.5%). The mean hopelessness score was 5.93 ± 4.71. The mean scores for social support provided by family and friends were 10.89 ± 5.61 and 14.94 ± 4.16, respectively. Significantly negative correlations were observed between the mean scores of hopelessness and social support provided by family (P = 0.007; r = −0.270) and friends (P = 0.001; r = −0.327).Conclusion:According to the findings of the present study, Iranian patients with cancer have relatively mild levels of hopelessness and moderate levels of social support. Perceived social support was also found to affect the patients' hopefulness. Given the lack of studies on this subject, it is recommended that further studies are performed.

Background and Purpose: Prophylactic dressings play a significant role in the prevention of pressure injury. However, no herbal products have been used in this regard, so far. Therefore, the present study was designed with the aim of comparing the effect of Aloe vera gel, Calendula officinalis ointment and simple sacral prophylactic dressings on pressure injury development in patients admitted to intensive care unit. Materials and Methods: The sample of this clinical trial study consisted of 90 critically ill patients. Randomization was performed by head nurse in intensive care unit. Patients in group "A" received Aloe vera gel prophylactic dressing twice a day; patients in group "B" received Calendula officinalis ointment prophylactic dressing twice a day; and patients in group "C" received simple prophylactic dressing twice a day. The development of pressure injury was compared between these three groups after the intervention. Results: Demographic variables were similar in all three groups (p> 0.05). The results showed that 3 patients (10%) who received the simple dressing, 2 patients (6.6%) who received the Calendula officinalis ointment dressing were wounded, while the development of pressure injury in patients who received the Aloe vera gel dressing was zero. The results of chi-square test showed that the frequency distribution of the pressure injury development in the two groups receiving Aloe vera gel and simple dressing was different. This difference was statistically significant (p < 0.05). However, there was no significant difference between the Aloe vera gel and Calendula officinalis ointment groups as well as the Calendula officinalis ointment group and the simple dressing. Conclusion: The results of the present study demonstrated that using Aloe vera gel and Calendula officinalis ointment prophylactic dressing twice a day can be effective in prevention of pressure injury in patients admitted to intensive care unit.

Authors' contributionsFR, MV, AE, and M.S. designed the study. M.V, PG and SJ provided methodological guidance. AE and FR conducted the interviews and performed the analysis under the supervision. All authors were responsible for writing the article and agreed with the final version to be published. Background: Safe nursing care is a key aspect of risk management in the healthcare system. The

In Iran, nurses are responsible for administering parenteral nutrition (PN) to hospitalized patients in intensive care units (ICUs). However, little information is available among nurses in Iran regarding best practices in PN administration. This study evaluates the performance of critical care nurses in Iran in the administration of PN. The performance of 50 nurses in the administration of PN in the ICU was observed 3 times during a 5-month period for a total of 150 observations. A researcher-developed checklist, “Critical Care Nurses' Performance in Parenteral Nutrition Administration,” was used for data collection. The total score in this checklist ranged from 0 to 52. Based on the procedural steps in the checklist and whether the steps were performed appropriately, nurses' performance was scored as poor, moderate, or good. The mean score of nurses' performances in PN administration skills was 24.6 ± 2.5. This study found that 46 nurses had moderate skill levels in PN administration, and 3 demonstrated poor skills. Overall, the results indicated that critical care nurses in Iran have poor to moderate PN administration skills.

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Introduction: The workload on nurses can have adverse effects on the patient, nurse and healthcare system such as reduced quality of care, increased risk of nursing errors, reduced patient satisfaction, increased nurse anxiety, increased nursing job stress, increased risk of infection, increase in the length of hospital stay and increased risk of death. Aim: The present study was designed and conducted to compare nurses’ workload in the Intensive Care Unit (ICU), Neonatal Intensive Care Unit (NICU), and Coronary Care Units (CCU). Materials and Methods: The present study is a cross sectional analytical study that was conducted in the ICU, NICU and CCU of educational hospitals affiliated to Qazvin University of Medical Sciences. The convenience sampling method was used. A nursing activity score was used to assess nurses’ workload. The total score in this instrument is between zero and 178. Data were analysed using SPSS 16. Pearson correlation coefficient, chi-square, independent t-test, one-way analysis of variance was used. Results: The mean score of the total workload in nurses was 104.19±25.18. Regarding the primary purpose of the study, the results of the present study showed that the mean score of nurses’ workload was significantly higher in nurses working in the NICU than nurses working in the ICU and CCU (p<0.05). Among the demographic variables, only the marital status was significantly associated with nurses’ workload, that married nurses experienced more workload in some shifts (p<0.05). Conclusion: Nurses working in NICUs experienced a higher level of workload compared to the nurses in ICU and CCU. Due to the high workload of nurses in the NICU and the complications that this can cause for neonatal patients and nurses, it is necessary to pay more attention to the distribution of nurses in these wards.