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.
SERVQUAL model is a popular remarkable tool for assessing the quality of educational services. The main of this research is exploring lived Experiences of Management Intern Nursing Students in the Clinical Settings of the Quality of Educational Services Using the SERVQUAL Model. Methods: This is a qualitative study was conducted by using a phenomenological approach. The study population consisted of the 8th semester nursing students spending management internships in the wards of teaching hospitals of Zabol and Zahedan located in southeastern Iran. The study participants were selected by using both the convenience sampling and the purposeful sampling. The participants were 22 eligible students. Interviews were conducted in a secluded and open environment for collected data. Results: The analysis results of the interviews can be divided into five main themes and 15 subthemes. Main themes are Conflict over physical resources, the inadequacy of facilities and equipment, Lack of coordination among employees, Challenges of responsiveness in the ward, Conflict in confidence, Double empathy. Conclusion: It is therefore recommended that research to be conducted in several teaching hospitals with different facilities at the same time in order to generalize the results.
Background & objective: Patients treated with mechanical ventilation may need sedatives and analgesics due to discomfort, pain, lack of coordination with the device, immunity maintenance, and oxygenation elevation. The use of sedation scoring protocols and systems reduces the duration of mechanical ventilation and hospitalization. Therefore, this study aimed to investigate the effect of controlled sedation based on the Richmond model on the duration of mechanical ventilation in patients admitted to the ICU. Methodology: This experimental study was performed on 60 patients admitted to ICU, who had been selected by simple random sampling and divided in two intervention and control groups. The data collection tools included the Richmond Agitation Sedation Scale (RASS), and Berne separation program checklist. In the intervention group, intervention was performed according to the standard Richmond protocol, but the control group received only the routine care. After the intervention, data were collected at 24 hours, 48 hours and 72 hours after the intervention by SPSS-21 statistical software, and then were analyzed by descriptive statistics (mean, standard deviation) and inferential statistics (paired t-test, independent t-test and repeated measure).
Figure 2. A, complex decision tree using four parameters of DWI restriction, central necrosis, T2 map, and TMCE ratio; B, confusion matrix for the number of lesions on true and false predicted classes; C, scatter-plot for distribution of lesions based on the complex model. B, Benign; M, malignant; Y, yes; N, no.
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