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Background and Objective: Catheter Associated Urinary Tract infection (CAUTI) is one of the most prevalent hospital acquired infections which causes increased medical costs, hospital stay and mortality. Patients in critical care units are in a higher risk. The main purpose of the present study is the Identification of the effect of instruction and implementation of a preventive urinary tract infection bundle on the incidence of CAUTI. Materials and Methods: This was a before-after quasi-experimental study. 330 patients were included (185 patients in before and 145 in after the intervention). In both phases, the incidence of CAUTI, compliance with principles of CAUTI prevention, urinary catheter utilization and indications of catheter insertion were evaluated. CAUTI was identified based on the Center for Disease Control and Prevention/ National Healthcare Safety Network (CDC/NHSN) criteria with the online INICC software. Interventions included the instruction of the bundle to all health care workers in selected intensive care units and implementing interventions to improve facilities required for the implementation of the bundle. Results: No significant decrease was seen in the incidence of the CAUTI after the intervention (3.2 v/s 1.36 in 1000 catheter-day, p<0.388). The most prevalent indication for urinary catheter utilization in both phases, were critical monitoring of urine output (80.16% and 72.26%, respectively). Before the intervention, 1.6 % of catheterized cases were labeled inappropriate by the physicians. This increased significantly to 5.5% after intervention (P<0.001). Before the intervention, 37.5% of the catheters which were labeled inappropriate were removed which increased to 42/4% after the intervention insignificantly (P<0/709). From the 88 hours of compliance monitoring. The number of observed noncompliance cases before the intervention, which was 1941, decreased significantly after the intervention (P<.001). Conclusion: This study revealed that although instruction and implementation of the preventive bundle reduced CAUTI, this reduction was not significant. Future studies should be conducted with larger sample sizes and in longer periods. The most prevalent criterion for urinary catheter utilization was the need for critical monitoring of urine output. Instruction of the bundle reduced noncompliance with principles of urinary tract infection control.

Background: Heavy workload is one of the main problems of nurses working in intensive care units (ICUs). It not only decreases the quality and safety of patient care, but also increases human errors in health care, rate of hospitalization, and risk of mortality in patients. Workload evaluation and surveillance of patients enable authorities to allocate adequate staff to ICUs, leading to improved quality of patient care and treatment.

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Objective: Illness perception and self-care behaviors can result in higher levels of health behavior among hemodialysis patients. The present study aimed to assess the relationship between illness perception and self-care behaviors among hemodialysis patients who referred to the hospitals affiliated to Shiraz University of Medical Sciences in 2017. Method: In this descriptive cross sectional study, 216 hemodialysis patients who referred to the hemodialysis wards of the hospitals affiliated to Shiraz University of Medical Sciences were selected via convenience sampling. The study data were collected using a demographic information form, Brief Illness Perception Questionnaire (9 items), and a 15-item Self-care Behavior of Hemodialysis Patients Questionnaire. Then, the data were analyzed using independent t test and one-way ANOVA. Also, significance level was set at P < 0.05. Results: The mean age of the study participants was 30.15+6.65 years. Also, most of the participants were female (n = 125, 58%). The results revealed a significant relationship between illness perception and self-care behaviors among hemodialysis patients. A significant relationship was observed between the following items: daily weight control and perception of consequences (r = 0.200, p = 0.001), between contacting the physician at the time of shortness of breath and consequences (r = 0.209, p = 0.001), between weight control according to the physician’s order and consequences (r = 0.763, p = 0.001), and between adherence to fluids restriction and identity(r = 0.149, p < 0.05). Conclusion: Considering the relationship between illness perception and self-care, beliefs as illness perception have to be incorporated into self-care programs designed for hemodialysis patients so as to promote their self-care behaviors. These findings can be used for planning and implementing care for hemodialysis patients.

Objective. This work sought to determine the level of anxiety in relatives of patients admitted to CCUs and its relationship with spiritual health and religious coping. Methods. This cross-sectional study was conducted on 300 relatives of Cardiac Care Units patients in Jahrom, Iran. Required data was collected using the Spielberger State-Trait Anxiety Inventory (STAI), the Paloutzian-Ellison Spiritual Well Being Scale (SWBS), and the Pargament Brief RCOPE questionnaire. Results. The results showed that both levels of state and trait anxiety were moderate and the level of total spiritual health was high. Anxiety score had an inverse relationship with spiritual health (r=-0.52) and a direct relationship with negative religious coping score (r=0.25). However, no significant relationship was found between total anxiety score and positive religious coping (p>0.05). There was a direct relationship between spiritual health and positive religious coping (r=0.19), and an inverse relationship between spiritual health and negative religious coping(r=-0.36). Conclusion. According to the findings of the study, it is suggested to paying attention to the reinforcement of spiritual attitudes, beliefs, and religious coping strategies to reduce their anxiety in CCU patients.

Background: Brain stroke is the main cause of death and disability worldwide. This disease can cause major complications in patients and place a great burden of care on caregivers. Therefore, this study was conducted to determine the effect of telenursing on the burden of care in caregivers and the rate of complications in patients with acute brain stroke discharged from neurological wards. Methods: This two-arm parallel-group single-blind randomized clinical trial study was carried out on 72 patients with acute brain stroke discharged from neurological wards in Qom, Iran, in 2019. The patients and their caregivers were divided to control and intervention groups using random block allocation. In addition to the usual training of the ward, the intervention group received training and counseling based on their needs through phone calls for 4 weeks. However, the control group received only the usual ward training. Immediately after discharge from the hospital and 1 month later, the average care load in caregivers and urinary problems, bedsores, and the number of falls in patients were measured. A demographic questionnaire, Caregiver Burden Inventory, Braden Scale, Morse Scale, and a urinary problem checklist were used for data collection. The data were analyzed using the chi-square test, Mann-Whitney U test, independent t-test, and paired t-test by SPSS software (version 24). Results: After the intervention, the mean scores of the caregiver’s burden of care in the control and counseling groups were 35.22 ± 17.215 and 8.00 ± 7.556, respectively (P < 0.001). In addition, the counseling group experienced remarkably fewer urinary problems (P < 0.001) and falling (P = 0.011). Conclusions: This study showed that telenursing reduced the burden of care in caregivers and decreased urinary tract infections and the number of falls in patients with acute stroke. Therefore, nurses and healthcare providers can use this program to improve the lifestyle of patients with acute brain stroke and their caregivers.

Introduction: Asthma is one of the prevalent and costly diseases. Various studies have shown that self-care plays a major role in preventing the complications, improving the life quality, and reducing the care expenditures of asthma. Therefore, strengthening the asthma patients in caring for themselves and using planned trainings is highly necessary. Objectives: The present study aimed to investigate the effect of education on self-care learning in the patients suffering from asthma. Patients and Methods: The present interventional study was conducted on 80 patients referring to specialized clinics of Shiraz University of Medical Sciences who had the inclusion criteria of the study. The patients were selected through convenient sampling and randomly assigned to either the control or the intervention group. The educational intervention included five sessions of training on self-care. The study data were collected using a demographic questionnaire as well as a knowledge assessment test and the results were analyzed through the SPSS statistical software. Results: The study results revealed no significant difference between the two groups regarding the demographic variables. However, comparison of the mean of changes in the two groups› knowledge scores showed a significant increase in the intervention group›s knowledge score (P<0.001). Conclusion: The findings of this study confirmed the patients› need for learning self-care methods as well as the effectiveness of planned educational programs. Therefore, using and strengthening selfcare trainings are highly recommended for asthma patients in clinics.