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Background: The handover process is a vital part of patient safety continuity, particularly conducted between nurses at the end of shifts. Nurses often face challenges in handover due to a lack of self-efficacy and inadequate communication skills. The clinical supervision model, by providing emotional, educational, and organizational support, aids in skill acquisition and instills confidence. Objective: This study was conducted to investigate the effect of the clinical supervision model on nurses' self-efficacy and communication skills in the handover process within medical and surgical wards. Method: This experimental two-group (pre-and post-test) study was conducted in 2024 at selected hospital affiliated with Isfahan University of Medical Sciences, Isfahan, Iran. Convenience sampling was used, and participants were randomly assigned to either the intervention or control group. Data were collected using the ISBAR communication checklist, communication clarity, the Sherer General Self-Efficacy Scale (GSES), the Visual Analog Scale (VAS) for handover self-efficacy, and the Manchester Clinical Supervision Scale (MCSS). The clinical supervision model and routine supervision were implemented in six sessions for the intervention and control groups, respectively. Data were analyzed using SPSS version 16, employing independent t-tests, covariance analysis, paired t-tests, chi-square tests, and repeated measures ANOVA with a significance level of p < 0.05. Results: No significant differences were observed between the intervention and control groups in terms of baseline characteristics. Inter-group analysis indicated that there were no significant differences in the scores of self-efficacy, ISBAR, and communication clarity between the control and intervention groups before the intervention (P > 0.05). According to the intra-group analysis, the ISBAR and communication clarity scores in the intervention group significantly increased over time (p < 0.001), whereas no such increase was observed in the control group. The intervention group showed a significant increase in general self-efficacy (p < 0.001) compared to the control group. Although both groups showed a significant improvement in handover self-efficacy, the mean scores of the intervention group were higher than those of the control group (p < 0.001). The mean score of the Manchester Clinical Supervision Scale in the intervention group was 128.98, indicating the high effectiveness of implementing the clinical supervision model. Conclusion: The findings indicated that the use of the clinical supervision model improves self-efficacy and communication skills in the handover process of nurses in medical and surgical wards. Therefore, it is recommended to use this model in handover training to enhance the quality of care and improve patient safety. [ABSTRACT FROM AUTHOR]

Background: Delay in episiotomy wound healing can lead to infection. The application of natural antimicrobial agents isolated from herbal essences can be a good strategy to prevent the growth of bacteria and promote the wound healing process. Therefore, this study aimed to determine the effect of rosemary cream on episiotomy wound healing in primiparous women. Methods: This triple-blind randomized clinical trial was conducted on 80 primiparous pregnant women who were referred to the maternity ward of Shahid Motahari Hospital in Marvdasht, Iran, from September 2019 to March 2020. These women were randomly assigned into two groups of intervention (rosemary cream) and control (placebo), using variable quadruple blocks. Both groups applied the prescribed cream (in a dose of 2 cm) uniformly on the sutured area to cover it with the cream. The cream was applied twice a day for 10 consecutive days postpartum, and the rate of wound healing was evaluated by the researcher in the first 12 h and at days 4 and 10 postpartum using the REEDA scale. The data were analyzed using SPSS software (Version 19) through the Chi-square test, Mann-Whitney U test, student's t-test, and Fisher's test. A p-value less than 0.05 (P < 0.05) was considered statistically significant. Results: The mean ± SD REEDA score on the fourth day postpartum was obtained at 3.82 ± 0.93 and 4.25 ± 1.29 in the groups of rosemary cream and placebo, respectively (P = 0.17). However, the mean ± SD REEDA scores on the 10th day postpartum were determined at 0.75 ± 0.74 and 3.32 ± 2.54 in the rosemary cream and placebo groups, respectively, indicating a higher rate of episiotomy wound healing in the group of rosemary cream compared to placebo (P < 0.001). Conclusion: Based on the obtained results, it seems that rosemary cream can be effective in healing episiotomy wounds in primiparous women. However, further studies are suggested to confirm the findings of this study. Trial registration: This trial was registered in the Iranian Registry of Clinical Trials in 24/08/2019 with the IRCT ID: IRCT20190308042971N1. The first participant enrolled in this trial in September 2019. URL of registry: https://en.irct.ir/trial/40092. [ABSTRACT FROM AUTHOR]

Background: Delirium is a neurobehavioral syndrome, which is characterized by a fluctuation of mental status, disorientation, confusion and inappropriate behavior, and it is prevalent among hospitalized patients. Recognizing modifiable risk factors of delirium is the key point for improving our preventive strategies and restraining its devastating consequences. This study aimed to identify and investigate various factors predisposing hospitalized patients to develop delirium, focusing mostly on underlying diseases and medications. Method: In a prospective, observational trial, we investigated 220 patients who had been admitted to the internal, emergency, surgery and hematology-oncology departments. We employed the Confusion Assessment Method (CAM) questionnaire, The Richmond Agitation Sedation Scale (RASS), the General Practitioner Assessment of Cognition (GPCOG), demographic questionnaire, patient interviews and medical records. Multivariate logistic regression models were used to analyze the predictive value of medications and underlying diseases for daily transition to delirium.; demographics were analyzed using univariate analysis to identify those independently associated with delirium. Results: Two hundred twenty patients were enrolled; the emergency department had the most incident delirium (31.3%), and the surgery section had the least (2.4%); delirium was significantly correlated with older ages and sleep disturbance. Among multiple underlying diseases and the medications evaluated in this study, we found that a history of dementia, neurological diseases and malignancies increases the odds of transition to delirium and the use of anticoagulants decreases the incident delirium. Conclusion: Approximately 1 out of 10 overall patients developed delirium; It is important to evaluate underlying diseases and medications more thoroughly in hospitalized patients to assess the risk of delirium. [ABSTRACT FROM AUTHOR]

Background: Patient awareness plays an important role in integrating palliative care into the patient care process. Lack of awareness can create a negative attitude towards palliative care and affect patients' decisions during the treatment process. The present study was conducted to determine the level of knowledge about palliative care in Iranian patients with cancer. Methods: The descriptive study was conducted with a convenience sample of 103 cancer patients admitted to an oncology center in Yazd, Iran, A three-part questionnaire including demographic information, sources of palliative care information and the Palliative Care Knowledge Scale (PaCKS) was used to collect data. All statistical analyses were performed using software SPSS 21. Results: The mean age of patients was 36.2 ± 13.5 years. Of the total, 38.8% of patients received information about palliative care through the media and 36.9% from the treatment team. On a scale of 0 to 13, the mean PaCKS score was 6.7 ± 3.7. A 'good' level of knowledge was reported by 29.1% of participants; however 84.5% stated that they should leave other doctors at the time of receiving palliative care, 71.8% considered palliative care for patients in the last six months of life, 84.5% considered palliative care for patients with cancer, and 70.9% stated that palliative care encourages people to discontinue treatments aimed at treating their disease. Conclusion: Our study found most cancer patients have a moderate to weak level of knowledge and considerable misinformation about palliative care, which highlights the importance of providing palliative care education. The development of training programs in this area could play an effective role in improving patients' knowledge of palliative care. [ABSTRACT FROM AUTHOR]

Background: Providing safe and high-quality nursing care is an essential task of nursing. Nurses may be unable to provide patients with all of the necessary care for numerous reasons, such as an increase in the number of patients and a low number of nursing staff. Moreover, they may have to omit, postpone, or incompletely perform a series of care, referred to as missed nursing care. The purpose of this study was to translate and conduct psychometric testing of the MISSCARE Survey. Method: In this study, we accurately translated the MISSCARE Survey. Its acceptability, construct validity, and internal consistency were analyzed. This cross-sectional study was conducted in the summer of 2020 in educational hospitals in Ardabil, Iran. The participants were 300 nurses who worked in educational hospitals and were randomly selected. Results: Participants in this study included 300 nurses from five units, including general medicine (13.3%), COVID-19 (45.0%), surgery (18.7%), critical care unit (6.3%), and intensive care unit (16.7%), who worked various shifts, of whom 84.7% were female. The total content validity in Part A was 0.944, and that in Part B was 0.969. Part A was divided into three domains (necessary care, secondary care, and supportive care), and Part B was divided into five domains (communication, labor resources, material resources, responsibility, and unpredictable situations). In both parts, the chi-square index was < 3, and the RMSEA index was < 0.08. The internal consistency measured by Cronbach's alpha was 0.933 for Part A and 0.910 for Part B for the Persian version of the MISSCARE Survey. Conclusion: Based on the outcomes of this research, it can be concluded that the Persian version of the MISSCARE Survey is valid for use in Iranian hospitals and can be used to identify missed care and the reasons behind it. Nursing managers can also use it to improve the situation and provide the highest-quality care. [ABSTRACT FROM AUTHOR]

Objectives: Knowing about accurate customer expectations is the most important step in defining and delivering high-quality services. This study aimed to evaluate the preferences of patients referring to two hospitals in Kermanshah, Iran. Method: Discrete choice experiment (DCE) method used to elicit preferences of 328 patients who were admitted in two hospitals of Kermanshah city in the west of Iran. Literature review and experts opinion were used to identify a candidate list of attributes related to the quality of cares in hospitals. The final study attributes were quality of physician care, quality of nursing care, waiting time for admission, cleaning of wards and toilets, and behavior of staff. Experimental design applied to extract choice sets of hospitals. The data was analyzed by a conditional logit regression. Results: The regression results showed the most important predictors of hospital selection by respondents was the good quality of physician care (aOR: 3.18, 95% CI 2.61, 3.87), followed by friendly behavior of staffs (aOR: 2.03, 95% CI 1.81, 2.27), cleanness of wards and toilet (aOR: 1.61, 95% CI 1.40, 1.85), and finally quality of nursing cares (aOR: 1.13, 95% CI 0.89, 1.44). However, increasing waiting time made disutility in the study participants (aOR: 0.69, 95% CI 0.60, 0.80). Conclusions: Our study finding emphasized some potential opportunity of quality augmentation in hospital sector by paying attention to different quality attributes including quality of physician, friendly behavior of staffs, cleanness of hospital environment and finally quality of nursing cares. Considering patients preferences in decision making process could lead to substantial satisfaction improvement. [ABSTRACT FROM AUTHOR]

Background: Presenteeism describes the state in which staff who lack the conditions for being present at work and need rest and leave for various reasons (such as illness, low spirits, fatigue, etc.) are present at the workplace. Due to the lack of knowledge about the antecedents of presenteeism in nurses and the context-based nature of this concept, the present study was conducted to explain the reasons for presenteeism in nurses. Methods: This qualitative study was performed using the qualitative content analysis method. The study population consisted of 17 nurses working in different wards of hospitals. In this regard, data were collected from February to June 2020 using individual, face-to-face, in-depth, semi-structured interviews and were analyzed using qualitative content analysis. Results: The nurse without a nurse was a category introduced as an antecedent of presenteeism. In this respect, nurses experienced limited power, injustice, compulsory presence, inadequate structural facilities, damaged professional identity, manager-nurse disconnect, insufficient knowledge, physical and mental health complications, job stress, job burnout, multitasking, and impaired communication. Conclusion: The nurse, who has been responsible for caring, supporting, advising, advocating, and educating the patient, has now been left without a nurse. In other words, not nursing the nurse has given rise to the emergence of presenteeism. It is recommended that the results of this study be used in making health policies. The results of this study can make nurses' voices heard by health leaders and managers. A voice that has never been heard as it deserves. [ABSTRACT FROM AUTHOR]

Background: Nurses are at the forefront of providing health care services and their performance is largely determinant of the quality of health care. This study aims to investigate associations between professional self-concept (PSC) and WRQoL among nurses from selected hospitals in Bushehr and Shiraz cities (south of Iran), during the period of COVD-19 pandemic. Method: This study is designed as a cross-sectional study. Available sampling was performed among active nurses in the care wards of patients with Covid-19 in public hospitals in Bushehr and Shiraz. Data were collected using demographic information form, along with the work-related quality of life and professional self-concept questionnaires. SPSS software and univariate and multivariate linear regression statistical methods with a significance level of 0.05 were used to analyze the data. Results: The mean scores of the PSC and the WRQoL Scale in nurses were respectively 202.32 ± 38.19 and 68.81 ± 19.12. There was also a significant direct relationship between PSC and WRQoL. PSC together with work location and working experience could thus explain 34.6% of the variance in WRQoL, which was 26.5% for PSC. Conclusion: Considering the confirmation of the predictive role of nurses' PSC in their WRQoL in terms of planning and designing interventions to boost their WRQoL, attention to internal factors such as PSC is of utmost importance. [ABSTRACT FROM AUTHOR]

Background: The physical environment profoundly affects women's well-being during childbirth in family-centered unit. A LDRP, which is an acronym for labor, delivery, recovery, and postpartum that describes a maternity unit designed for family-centered care. This study aimed to design soothing LDRP healing architecture based on recognizing the emotional elements of Iranian women. Methods: This study will be conducted in four consecutive phases; including review of literature to provide documentation based on architectural knowledge and the effects of each architectural component on the parturient psychological conditions, qualitative study to extract women's needs and suggestions for physiological childbirth, architectural designing of the soothing LDRP based on the results of the first and second phases and qualitative study for evaluation of the designed program. Discussion: Designing soothing LDRP architecture based on safe child birth unit standards and favorable psychological environment will provide a positive childbirth experience for Iranian women and their family. But, the preferences and demands of families will be based on Iranian socio-cultural context, therefore the using of this design will be limited in other societies with different cultures. [ABSTRACT FROM AUTHOR]

Objective: Multi and extensively drug-resistant (MDR and XDR), Pseudomonas aeruginosa (P. aeruginosa) and Acinetobacter baumannii (A. baumannii) are two main causative agents of nosocomial infections leading to increased morbidity and mortality. We aim to study the prevalence of MDR and XDR-A. baumannii and P. aeruginosa phenotypes in clinical specimens. We conducted this for 1 year (2017–2018) and isolated bacteria from the clinical samples. Then, XDR and MDR strains were determined by susceptibility testing (disc diffusion). Results: Out of 3248 clinical samples, A. baumannii and P. aeruginosa strains were detected in 309(9.51%) of them. Susceptibility testing indicated that (16.50%) and (15.53%) of the P. aeruginosa and (74.75%) and (73.13%) of the A. baumannii isolates were screened as the MDR and XDR strains. The frequency of MDR isolates was higher in wound samples 222 (71.8%). This rate in behavioral intensive care unit (BICU) and restoration ward, were 187 (60.5%) and 63 (20.4%). The frequency of XDR isolates in BICU 187 (59.54%), restoration 58(18.77%), and burns 30 (9.70%) were assessed as well. Considering high isolation rates of MDR and XDR of mentioned strains, it is necessary to apply prevention criteria for eradication of the mentioned bacteria from hospital wards. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed at determining the relationship between religious commitment and moral sensitivity among nurses working in the ICU sections in the west of Iran. The present study was a cross-sectional descriptive-analytic study carried out on nurses working in ICU wards of two western cities in Iran. The instrument used includes a demographic questionnaire, religious commitment questionnaire and moral sensitivity questionnaire in nurses. First, the researchers referred to the ICU wards of the hospitals in the cities after receiving permission from the relevant authorities by referring to three shifts in the morning, evening and night shifts and holidays. The researchers, while explaining the research goals for the nurses participating in the study, obtained their informed consent to participate in this study. Results: According to the findings, mean (SD) of the overall score of religious commitment was equal to 36.38 (4.58) and mean (SD) of MS score of nurses was 59.21 (12.65). Also, 91 nurses (82.7%) had average MS, 7 (6.4%) had low MS and 12 (10.9%) had high MS. [ABSTRACT FROM AUTHOR]

Background: One of the most common orthopedic problems is the incidence of pressure ulcer followed by immobility. This study aimed to investigate the effect of Aloe Vera gel on the prevention of pressure ulcer in patients hospitalized in the orthopedic ward. Method: This study is a randomized, triple-blind clinical trial which was done on 80 purposefully selected patients in orthopedic ward in Arak town, Iran, 2016. Patients were randomly assigned into two intervention and control groups based on blocking sampling method. In each group the routine daily cares to prevent bed sores were performed by nurses. In the intervention group in addition to routine nursing care to prevent bed sores, twice a day (hours of 9 and 21) pure Aloe Vera gel on the areas of hip, sacrum and heel were rubbed, but in the control group placebo (gel of water and starch) were used. Then sacral, hip and heel of both groups on days 3, 7 and 10 for of signs of pressure ulcers was evaluated. Results: The mean age of patients in the control group was (42.34 ± 12.19) and in the intervention group Was (41.71 ± 11.50) years, respectively. In the intervention group 1 patient afflicted with sore of hip and two people with sacral pressure ulcer. In the control group 3 patients affiliated with sore of hip, 8 people with sacral pressure ulcer, and 1 person had pressure sore of heel. Analysis of the data showed that both groups had statistically significant differences in the incidence of pressure ulcers (P = 0.047). This means that Aloe Vera gel could prevent the occurrence of pressure ulcers in the intervention group. Conclusion: Due to the effect of Aloe Vera gel to prevent a rise in temperature, non-blanchable redness, swelling and pain of the skin of regions under study in hospitalized patients in the orthopedic ward, applying of it toward the prevention of pressure ulcers in patients at risk of pressure ulcer development is recommended. Trial registration: This study was registered in Iranian Registry of Clinical. Trials in 07/09/2016 with the IRCT ID: IRCT2016051027825N1. [ABSTRACT FROM AUTHOR]

Background: Medical errors are considered as a major threat to patient safety. To clarify medical errors' status in Iran, a review was conducted to estimate the accurate prevalence of medical errors.Methods: A comprehensive search was conducted in international databases (MEDLINE, Scopus and the Web of Science), national databases (SID, Magiran, and Barakat) and Google Scholar search engine. The search was performed without time limitation up to January 2017 using the MeSH terms of Medical "error(s)" and "Iran" in Endnote X5. Article in English and Persian which estimated the prevalence of medical errors in Iran were eligible to be included in this review. The JBI appraisal instrument was used to assess the quality of included studies, by two independent reviewers. The prevalence of medical errors was calculating using random effect model. Stata software was used for data analysis.Results: In 40 included studies, the most frequent occupational group observed were nursing staff and nursing students (21 studies; 52% of studies). The most reported type of error was medication error (25 studies; 62% of studies, with prevalence ranged from 10 to 80%). University or teaching hospitals (30 studies; 75% of studies) as well as, internal/intensive care wards (10 studies; 25% of studies) were the most frequent hospitals and wards detected. Based on the result of the random effect model, the overall estimated prevalence of medical errors was 50% (95% confidence interval: 0.426, 0.574).Conclusion: Result of the comprehensive literature review of the current studies, found a wide variation in the prevalence of medical errors based on the occupational group, type of error, and health care setting. In this regards, providing enough education to nurses, improvement of patient safety culture and quality of services and attention to special wards, especially in teaching hospitals are suggested. [ABSTRACT FROM AUTHOR]

Background: Enterococcus species continues to be an important cause of hospital-acquired infection worldwide. This study was designed to determine the antibiotic resistance profiles, virulence genes and molecular characteristics of Enterococcus faecium strains isolated from an Iranian children hospital in a four-years period. Results: A total 189 Enterococcus strains, comprising 108 (57%) E. faecium, 67 (35%) E. faecalis and 14 (7%) isolates of other spp. were isolated during the collection period. More than 92% of E. faecium isolates were resistant to ampicillin (92.5%), ciprofloxacin (96%), erythromycin (100%) and clindamycin (96%). A high frequency of resistance to clindamycin (100%), erythromycin (98.5%) and ciprofloxacin (80.5%) was observed among E. faecalis isolates, while resistance to ampicillin (7%) was less frequent. The prevalence of vanA gene among vancomycin resistant E. faecium and vancomycin resistant E. faecalis was 95 and 50%, respectively. The analysis of 108 E. faecium isolates revealed 34 variable number tandem repeat (VNTR) patterns and 27 Multi Locus VNTR Analysis (MLVA) types (MTs). Conclusions: The results show a shift from E. faecalis to E. faecium as the dominant enterococcal species among patients at the children Hospital. Our data revealed that the majority of E. faecium isolates (66%) belonged to three common MTs and these types were isolated from different wards in children hospital. [ABSTRACT FROM AUTHOR]