Background and Objectives:Hospital-acquired infection (HAI) is one of the common problems and difficulties faced by hospitals in all countries around the world. Since nurses are part of the healthcare team that plays a unique role in the control of hospital infection, this study is conducted to analyze the knowledge and practice of healthcare personnel about standard precautions for hospital infection.Materials and Methods:This descriptive study was conducted on 170 nurses worked in medical surgical wards, pediatric wards, dialysis units of two teaching hospitals in Zabol city, Iran, in 2014. The sample population was selected through simple random sampling. The data collection instrument is composed of a researcher-made questionnaire titled “Hospital-acquired infection Control” based on precautions posited by the World Health Organization (WHO) and the United States Centers for Disease Control and Prevention (CDC). Data were fed into the SPSS software v.20 and were analyzed using descriptive and inferential statistics.Results:The results show that 43% of the participants in this study had poor knowledge, 42% had average practice, and 37% had a moderate attitude about hospital infection. There was a significant relationship between knowledge and gender (r = 00.8 p = 0.02). However, the variables of age, marital status, employment, work experience, education, and place of work did not establish a significant relationship with the independent variables (p>0.05).Conclusion:As the results indicate a low level of awareness among the personnel about hospital infection, it is suggested to provide training sessions on the prevention and control of HAI to increase the awareness of personnel and hold practical courses for practicing these principles.

Background: Pneumonia is one of the most common hospital-acquired infections, where 86% is associated with mechanical ventilation, known as ventilator-associated pneumonia (VAP). Oropharyngeal decontamination reduces the incidence of VAP by medicinal agents. Objectives:The aim of the present study was to determine the effect of oropharyngeal decontamination using topical antibiotics on oropharyngeal and tracheal colonization of trauma patients admitted to the intensive care unit (ICU). Methods: The present double-blind clinical trial was performed on trauma patients, who underwent endotracheal intubation during the first 24 hours, at the ICU of Khatam-al-Anbia Hospital, Zahedan, during years 2017 to 2018. The sample size was 100 individuals, who were selected using the convenience sampling method and randomly assigned to intervention and control groups. The study began with the start of intubation and lasted for five days. When oral and tracheal culture samples were sent to the laboratory during the first 24 hours after endotracheal intubation, the pre-mixed solution of nystatin, polymyxin B, and neomycin was rubbed to the mouth, lips, gingiva, and cheeks of the intervention group, using syringes and gloves, four times a day. The tracheal and oral secretions were cultured in the intervention and control groups at the beginning and the end of the study. Data analysis was carried out using the SPSS version 21 software. Independent t test and paired t test were used to compare the quantitative variables, and qualitative variables were compared using the chi-square test and Fisher's exact test. The significance level was considered at 0.05. Results: When the final drop-out occurred, out of 44 remaining patients in the intervention group, the number of negative oral cultures increased from 31 cases (70.5%) in the pretest to 39 (88.6%) in the posttest. A total of 25 negative oral cultures were recorded in the control group in both the pretest and posttest stages. Also, the number of negative tracheal cultures in the intervention group increased from 38 cases (86.4%), in the first turn, to 44 (100%) cases in the second turn; while in the control group, the number of negative tracheal cultures was recorded as 39 (88.6%) in the first turn and increased to 40 cases (100%) in the second turn. Conclusions: Clinically, reduced colonization rate of invasive bacteria, as the main result of the present study, indicates a decrease in the incidence of inappropriate alterations in oral microbial flora that can subsequently be effective in reducing the incidence of diseases, such as pneumonia.

Background: Breast cancer is the most common cancer among women worldwide. A very important factor in the timely treatment and prevention of progression is high breast cancer awareness. Rural women are at risk of latte stage breast cancer due to poor education and lack of access to medical facilities. Materials and Methods: This cross-sectional-descriptive study was conducted on 266 women (out of 300) aged over 18 in rural areas of Zabol, Southeastern Iran during July 2015 to October 2015. The data collection tool was a researcher-made questionnaire that measured participant knowledge of breast cancer in four aspects (general awareness, risk factors, mammography, and symptoms). SPSS 22 was used for statistical analysis. Results: Out of 266 participants, age information was available for 261. The age range was between 19 and 62, with a mean of 27±2.1 years. Most participants (154, 57.9%) had an average overall awareness of breast cancer. In the general awareness dimension, most participants (130, 48.9%) had poor scores. Most (166, 62.4%) also had average awareness about risk factors and many (137, 51.5%) had good awareness about mammography. Most participants did not know that changes in breast shape (232, 88.2%), dimpling of breast skin (192, 72.3%) and nipple discharge (183, 69.6%) are the main symptoms of breast cancer. ANOVA statistical analysis showed a significant relationship between awareness level and participant education and occupation (P<0.05). Conclusions: This study indicated average awareness of participants about breast cancer. Since rural women have lower levels of education, it is recommended that educational courses with contents about breast cancer, its risk factors, and symptoms be held for these women.

Background: Agitation in mechanically ventilated patients with decreased consciousness is a challenge in the ICU and a threat to the process of mechanical ventilation. On the other hand, controlling agitation through medication and imposing physical limitations is associated with a number of undesirable side effects. Objectives: This study aimed to determine the effect of auditory and tactile stimulation by a family member on the level of agitation in patients with traumatic brain injury (TBI) and decreased consciousness. Methods: This quasi-experimental study was performed on 80 TBI patients with decreased consciousness who were admitted to the ICU of two teaching hospitals in southeastern Iran in 2019. Qualified patients were selected by convenience sampling and then randomized into the intervention (n = 40) and control (n = 40) groups. Data collection tools included a demographic form and the Richmond Agitation and Sedation Scale (RASS). For patients in the intervention group, the researcher first completed the demographic form and the RASS. Then, they underwent the experiment, which consisted of auditory and sensory stimulation by a family member for 10 minutes. After 30 minutes, the agitation level was measured again. This experiment was performed for seven consecutive days between 16:00 and 18:00 o’clock. Patients in the control group, however, did not receive any intervention other than routine care in the ICU. Data were analyzed in SPSS version 21 by using descriptive statistical tests and independent t-test, paired t-test, [analysis of] covariance, and chi-square test at the significance level of P < 0.05. Results: The results indicated no significant difference in the level of agitation in the intervention and control groups between the first and fifth days; however, independent t-tests and analysis of covariance revealed that the patients who received auditory and tactile stimulation on the sixth and seventh days experienced significantly lower levels of agitation than the control group (P < 0.01). Conclusions: Auditory and tactile stimulation by family members is effective in decreasing the agitation of TBI patients with decreased consciousness. Therefore, it is suggested as a helpful intervention in nursing care programs.

Background: There are several factors such as noise and light, which affect the sleep quality of patients admitted to the cardiac care unit (CCU) and cause sleep disorders in these individuals. Objectives: The purpose of this study was to compare the impact of applying eye masks and earplugs as well as implementing the quiet time (QT) protocol on the sleep quality of patients hospitalized in the CCU of Ali Ibn Abi Talib Hospital in Zahedan. Methods: This clinical trial was performed on 135 CCU patients. Subjects meeting the inclusion criteria were chosen through convenience sampling. The patients were divided into three groups (control, eye mask and earplugs, and QT protocol) and were matched in terms of background variables. The subjects were studied over three days after admission. On the first night, the patients' sleep quality was determined by the Verran and Snyder-Halpern Sleep Scale (VSH), and on the second and third nights, the interventions (eye mask and earplugs and QT protocol) were administered. The next day, as the post-test, patients' sleep quality was measured again. ANOVA test was used to determine and compare the mean sleep quality of the three groups, and the chi-square test was employed to compare the qualitative variables in the three groups. Results: After the intervention, the mean score of sleep disturbance was significantly different between the control and the two experimental groups. Also, the mean score of sleep efficacy was higher in the eye mask and earplugs group than the other two groups, indicating a better sleep quality in this group. Conclusions: As low-cost devices with no side effects, eye masks and earplugs can improve the quality of sleep in [CCU] patients, and nurses could utilize them to help reduce environmental factors, which disturb patients' sleep.

BACKGROUND: Pruritus is a common skin manifestation in patients undergoing hemodialysis. Pruritus has a negative impact on the quality of life of patients receiving hemodialysis. This study was aimed to investigate the effect of foot reflexology massage on pruritus in hemodialysis patients. MATERIALS AND METHODS: A quasi-experimental study was conducted on 90 hemodialysis patients referred to Khatam-al-Anbiya and Ali-Ebne Abi-Taleb hospitals affiliated to Zahedan University of Medical Sciences in 2019. Patients with moderate-to-severe pruritus scores obtained from the Pruritus Severity Scale (PSS) were included in the study. They were randomly divided into intervention and control groups using shuffling cards or envelopes. The intervention group received nine sessions of foot reflexology massage 3 days a week for 20 min (10 min on each foot) with an emphasis on the solar plexus point. The participants in both groups again completed the PSS 48 h after the intervention. Data were analyzed using the SPSS version 24, independent t -test, Chi-square test, and paired t -test. RESULTS: The results of this study demonstrated that foot reflexology massage significantly reduced itching or pruritus in hemodialysis patients ( P < 0.001). Pruritus scores in the control group were statistically significant ( P < 0.001). There was no significant statistically difference between the two groups in terms of the pruritus scores before the intervention ( P = 0.59). CONCLUSION: Our findings showed that the foot reflexology massage could relieve itching or pruritus in hemodialysis patients. It is, therefore, recommended that it can be used as an effective intervention technique to alleviate itching in hemodialysis patients.

Background As a main challenge in paramedical faculties of medical sciences, freshmen lose interest in their academic field of study and then job motivation. Lack of developed knowledge about their academic field and unfamiliarity with their future job’s tasks and roles contribute to freshmen’s job motivation loss. Various interventional programs have been implemented to improve students’ job motivation by familiarizing them with their future job’s duties and responsibilities. Methods This was one-group pretest-posttest design study in 2019–2020. Students grouped into pairs of a freshman (shadowee) with a senior (shadower) in a clinical setting during shadowing program. This program helps freshmen to comprehend and discover realities of their academic field and can help them change their perspectives regarding their future job’s duties and responsibilities. The shadowees’ main task was reflective observation on operating room events and interactions and to be active in the program, several tasks e.g., how to wear gloves, guns, and disinfect equipment were assigned to them exclusively under the supervision of senior students. The Hackman and Oldham’s Job Diagnostic Survey (JDS) questionnaire and a novel Job Motivation Survey (JMS) questionnaire were distributed among participants. Results Fifty freshmen majoring in operating room participated in the shadowing program from November 2019 to January 2020. Before and after the program, they completed Hackman and Oldham’s job diagnostic survey and researcher-made job motivation survey questionnaires. Results were indicative of a significant difference in job diagnostic survey questionnaire score, where overall pre-test and post-test scores before and after the intervention were 57.78 (±9.78) and 68.58 (±5.02), respectively; the score difference was statistically significant (P < 0.001). Moreover, the overall pre-test and post-test scores of the job motivation survey questionnaire were 25.16 (± 9.75) and 39.80 (±5.18), respectively; this score difference was statistically significant (P < 0.001). Conclusion Shadowing program improved freshmen’s realistic perception of their future job’s duties and responsibility, and hence enhancing their job motivation and job recognition. As future work, in various disciplines, further studies need to evaluate the impact of such interventional programs in providing early insights for freshmen as well as in providing guidance on their plans for education, and future job.

Background: Urinary tract infection is the most common site of infection associated with health care in the Intensive Care Unit (ICU) patients. Long-term catheterization is the most important risk factor for Urinary Tract Infections (UTIs). These infections are more common in women than in men. Colonized microorganisms in the perineal skin and around the urethra may move into the urinary system through the external surfaces of the urinary catheter to cause infection. Objectives: The present study aimed to compare the effect of perineal care with normal saline and 2% chlorhexidine solution on the rate of catheter-associated urinary tract infection (CAUTI) in women hospitalized in ICUs. Methods: A quasi-experimental study was performed on 70 female patients hospitalized in the ICU of Khatam-Al-Anbia Hospital of Zahedan in 2019. The research units meeting the inclusion criteria were selected using convenience sampling and then randomly divided into two groups of normal saline (n = 35) and chlorhexidine (n = 35). The perineal area of patients in the first group was washed with normal saline and the second group with 2% chlorhexidine solutions twice a day for seven days in both groups. To diagnose UTIs, urine samples were cultured on the first and seventh days. Data were analyzed using SPSS 21 via the independent t-test, chi-square test, and Fisher’s exact test at a significance level of less than 0.05. Results: Finally, 60 participants completed the study. The two groups did not differ significantly in terms of age, marital status, level of education, cause of hospitalization, antibiotic use, underlying diseases, fluid intake, and urinary output. At the end of the seventh day after the intervention, the incidence of UTIs was significantly lower in the chlorhexidine group (13.3%) than in the normal saline group (76.7%) (P = 0.001). Conclusions: The results showed that washing the perineal area every 12 hours with 2% chlorhexidine solution compared to normal saline reduces the incidence of CAUTIs in women hospitalized in ICUs. Therefore, perineal care with a 2% chlorhexidine solution is recommended for perineal care of female patients with urinary catheters hospitalized in ICUs.