Background and Objectives:The dangerous events caused by medication errors are one of the main challenges faced in critical care units. The present study was conducted to determine the frequency of intravenous medication administration errors and their causes in cardiac critical care units in Iran.Materials and Methods:The present descriptive study was conducted in the critical care units (CCUs and cardiac surgery intensive care units) of 12 teaching hospitals. Of the total of 240 nurses working in these departments, 190 participated in the present study. The data collection tools used in this study included the “nurses’ demographic data questionnaire”, the “patients’ medical and demographic data questionnaire” and the “nurses’ self-reporting questionnaire about the frequency of intravenous medication administration errors and their causes”. The data obtained were analyzed in SPSS-20 using descriptive statistics such as the absolute and relative frequency.Findings:During the 2 months in which this study was being conducted, 2542 patients were admitted to these departments and 20240 doses of intravenous medications were administered to these patients. The nurses reported 262 intravenous medication administration errors. The most common intravenous medication error pertained to administering the wrong medication (n=71 and 27.1%). As for the causes of intravenous medication administration errors, 51.5% of the errors were associated with work conditions, 24% with packaging, 13.4% with communication, 9.9% with transcription and 1.2% with pharmacies.Discussion and Conclusion:According to the results, strategies are recommended to be adopted for reducing or limiting medication errors, such as building a stronger pharmacology knowledge base in nurses and nursing students, improving work conditions and improving communication between the nurses and physicians.
Purpose: Medication nonadherence is one of the most important reasons for treatment failure in patients with epilepsy. The present study investigated the effectiveness of a multicomponent intervention to improve adherence to antiepileptic drug (AED) medication in patients with epilepsy. Methods: In a prospective, randomized multicenter trial, three sessions of face-to-face motivational interviewing (MI) in combination with complementary behavior change techniques were compared with standard care. Motivational interviewing prompted change talk and self-motivated statements from the patients, planning their own medication intake regimen and also identifying and overcoming barriers that may prevent adherence. Participants were provided with calendars to self-monitor their medication taking behavior. A family member and the health-care team were invited to attend the last session of MI in order to improve the collaboration and communication between patients, their caregiver or family member, and their health-care provider. At baseline and 6-month follow-up, psychosocial variables and medical adherence were assessed. Results: In total, 275 participants were included in the study. Compared with the active control group, patients in the intervention group reported significantly higher medication adherence, as well as stronger intention and perceptions of control for taking medication regularly. The intervention group also reported higher levels of action planning, coping planning, self-monitoring, and lower medication concerns. Conclusions: This study shows that MI can be effective in clinical practice to improve medication adherence in patients with epilepsy. It also provides evidence that combining volitional interventions, including action planning, coping planning, and self-monitoring with motivational interviewing can promote the effectiveness of the medical treatments for epilepsy by improving adherence.
Background: The number of patients with chronic renal failure is increasing in Iran. Quality of life is an important indicator that reveals the sense of well-being, positive understanding of their, and the effectiveness of health care in patients undergoing dialysis, which could be affected by duration of dialysis. Objectives: This study aimed at investigating the relationship between quality of life and duration of dialysis in hemodialysis patients. Methods: In this descriptive correlational study, 246 patients with chronic kidney failure were selected by Single-stage stratified cluster sampling. Hemodialysis patients were put into 2 groups with a duration of hemodialysis less than and more than 36 months and were then compared with each other. The quality of life was measured using the kidney disease quality of life short form (KDQOL-SF36). Data analysis was performed by the Pearson correlation coefficient, independent t-test, and ANOVA Results: The mean duration of hemodialysis patients was 34.03 months. There was no significant relationship between the quality of life in patients and duration of hemodialysis. Poor quality of life had a significant correlation with old age (P < 0.001), educational level (P < 0.001), job, and income (P < 0.001). Conclusions:The findings showed poor quality of life in patients on dialysis. The length of the disease and other accompanying diseases reduced the quality of life in dialysis patients as their age increased. It is evident that educated people who have better access to sources of support and are able to cope with disease complications have a higher quality of life.
The aim of this study was to provide the first report of incidence of leptospirosis and to determine the epidemiology of this zoonotic disease in Mazandaran Province, North of Iran. In the period of one year, from April 2007 to April 2008, forty seven confirmed reports of human cases of leptospirosis was received by Mazandaran Health Centre from local hospitals and leptospirosis laboratory. The annual incidence rate for the total population was 1.6 per 100,000 person-year. The majority of cases were males (84.1%). The maximum number of cases was seen to occur between 40 and 59 years of age. Seasonal outbreak of leptospirosis was seen in summer (70.3%). Farmers (57.4%) more frequently affected by disease than other occupations. In conclusion, it is necessary for medical practitioner to pay attention to leptospirosis in farmers during summer season.
Background: Hemodialysis patients are faced with challenges in carrying out their daily activities. Self-efficacy is a social cognitive concept that can affect behavioral control in these patients. Hence, the purpose of the present study was to investigate the effects of exercise training on physical performance and self-efficacy in hemodialysis patients. Materials and Methods: This randomized controlled clinical trial was conducted on 60 hemodialysis patients who visited hospitals affiliated to Mazandaran University of Medical Sciences in Sari, Iran. The participants were randomly divided into two groups. The patients in the intervention/exercise group received the 8-week exercise program. Patients in the control group received routine care. The Six-Minute Walk Test (6MWT) was used to assess the patients' functional ability and the Exercise Self-Efficacy Scale (ESES) and Chronic Disease Self-Efficacy Scale (CDSES) were used to assess their self-efficacy before and 2 and 8 weeks after the intervention. For statistical analysis, independent t -test and paired t -test were used. Results: The comparison of self-efficacy between the exercise group and control group after 8 weeks of intervention showed a significant difference between the groups in terms of the CDSES (F 1,43 = 22.92, p < 0.001) and ESES (F 1,38 = 10.84, p < 0.001) results. Moreover, the comparison of mean distance walked based on the 6MWT showed significant changes in this variable (F 1 = 2.05, p = 0.015). Conclusions: The designed exercise program can improve self-efficacy and physical performance in hemodialysis patients. This intervention is recommended for hemodialysis patients due to its effectiveness, simplicity, and uncomplicated characteristics
Introduction:As the most common postoperative pulmonary complications after cardiac surgery, atelectasis is one of the most important and serious early postoperative complications and one of the most important causes of prolonged hospitalization, increased costs, and mortality rise. Therefore, the present study was aimed at specifying the frequency of atelectasis in patients following coronary artery bypass graft and its associated factors in Mazandaran Heart Center in 2013-2014.Materials:The present investigation was a descriptive cross-sectional study in which sequential sampling was used. It was conducted on 375 patients whose coronary artery bypass graft had been performed by the same surgeon and anesthesiologist. For data collection, first the patients’ demographic variables and the information of their surgery were retrieved through their profiles, direct observation, patient inquiry, and the collected data were recorded in the data collection forms. Then, atelectasis was measured before the surgery and on the first and second days after it by taking CXR whose results were checked by two radiologists who were not aware of the previous observations. Data were analyzed through t-test, Pearson test, and Chi-square test using SPSS 16.0.Results:The results of the present study indicated that, 123 out of 375 patients (32.8%) were diagnosed with at least one type of tattletales during the first three days after the surgery. The mean age of the patients who were diagnosed with atelectasis was 62.9 and most of them were female. The results also showed that there was a significant relationship between postoperative frequency of atelectasis and the patients’ pulmonary diseases and underlying diseases like diabetes and hyperlipidemia, smoking and alcohol use before the surgery, and transfusion of 4 units of packed red blood cells during the surgery (p<0.05).Conclusion:Atelectasis is the most common postoperative complication which emerges more in patients with pulmonary and underlying diseases than other patients.
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