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Background: Nursing organizations are an essential part of the nursing profession. The main mission of nursing organizations is to establish new nursing roles based on changes in societal needs. This study conducted a situational analysis of the nursing organizations' life cycle and their effects on nursing role development in Iran. Methods: This study used a grounded theory methodology called situational analysis based on the Clack framework (2018). The sources of data collection included interviews, analysis of documents at Dr Madah Association and the National Library of Iran, statistics, government documents, international reports, and historical articles about nursing organizations, as well as reports on the role of licensed practical nurses (LPNs) and registered nurses (RNs). Data were collected through semi-structured and in-depth interviews with 33 nurses. Interviews continued until data saturation was reached. Results: Researchers identified 7 trends that reflect the evolution of nursing organizations and the health care system, as well as the factors that influenced the development of nursing roles. The 7-step trends were marked with letters A to G. Each letter indicated a map of concepts related to the role of nursing. Conclusion: The process of developing the role of nurses in Iran, at the senior management level, struggles with the unbalanced distribution of budget in the health system. Therefore, nursing leaders need to foster their interaction and diplomacy to be able to strike a balance between the micro, middle, and macrostructures of nursing.

Abstract Background The primary objective of clinical practice in nursing education is to achieve mastery of clinical skills through repetitive practice. Therefore, there exists a correlation between the frequency of skill demonstration and clinical competency. This study aimed to address the following question: How many times should a nursing student perform burn wound dressing to attain clinical competency? Methods This time series study was conducted on 41 junior nursing students who were selected through a census sampling method at Neyshabur School of Nursing from spring 2015 to summer 2021. The data collection tool was a researcher-made competency evaluation checklist (CEV). The competency score of each student for each skill demonstraion episode was evaluated using the Competency Evaluation Checklist (CEV) and recorded on the learning curve until a plateau was reached. SPSS16 and repeated measures analysis of variance (ANOVA) were used. Results The mean competency score of burn wound dressing was 67.5 ± 11.0 (out of 100) during the first attempt, which increased to 95.9 ± 4.3 by the ninth attempt. The learning curve for the burn wound dressing skill reached a plateau after five attempts. Additionally, by the fifth attempt of dressing the burn wound, all students could accurately identify the depth, extent, and severity of the wound. Conclusions Establishing a standardized frequency for clinical skill performance and ensuring ample practice opportunities can have significant benefits in nursing education systems. These benefits include long-lasting learning, reduced costs, and improved effectiveness. As a result, nurse managers and lecturers should consider the resources available in their educational systems and strive to provide students with adequate opportunities and a supportive environment to practice their skills.

Introduction: Angioplasty is widely used as a selective treatment for acute coronary syndromes. The complications of this procedure often lead to an increase in the length of the patients’ stay and hospital costs. Therefore, this study aimed to determine the effect of using sand and ice bags on hematoma and hemorrhage after percutaneous coronary intervention (PCI). Methods: In this randomized clinical trial, study was completed with participation of 60 patients with femoral angioplasty candidate, referring to Imam Reza hospital in Mashhad, were randomly divided into control and intervention groups. In the control group, a sand bag was placed on the location for up to 4 hours. In the intervention group, the ice bag and the sand bag were used simultaneously for 15 minutes, and then for 45 minutes, with the pressure of the sand bag only. This cycle was repeated four times. Hemorrhage (volume and weight) and hematoma (area and lump) were checked four times. The data were analyzed using SPSS software version 22. Results: The rate of hemorrhage after intervention was significantly reduced in the intervention group compared to the control group. Although the incidence of hematoma in the intervention group decreased from control to 20% to 6.7%, but the statistical test was not significant. Conclusion: According to the results of the present study, the simultaneous sand-ice bag application can reduce post-PCI’ hemorrhage (and hematoma rate, though insignificantly) through compression and vasoconstriction.

Background & aim: Midwives have a substantial role in evaluating and improving sexual health and providing family counseling. The aim of this study was to evaluate clinical skills of midwifery students of Mashhad University of Medical Sciences in providing sexual health counseling services and determine their attitudes toward sexual relations of couples in the academic year of 2014-2015. Methods:This cross-sectional study was performed on 63 midwifery students, who were selected by convenience sampling. The data collection tools included an academic and demographic questionnaire, the questionnaire of attitudes toward couples' sexual relations, and a checklist to assess the midwifery students' clinical skills in taking sexual history, providing sexual counseling during pregnancy and menopause, and diagnosis and treatment of sexual dysfunction. The checklist was completed by observers in objective structured clinical test consisting of five stations. Data analysis was performed using descriptive statistics, One-way ANOVA, Pearson correlation, repeated measures ANOVA, and regression, using SPSS version 16. Results: The mean score of students' attitude was 34.1±4.0 out of 40, and 85.7% of the participants had a very good attitude toward sexual relation of couples. The mean total score of the students' clinical skill was 22.6±8.0 out of 128, and 90.5% of the samples were at a poor level. Conclusion: Although providing sexual health counseling services is among the educational purposes of midwifery students and is one of the qualifications midwifery students and midwives must have, midwifery students' do not have satisfactory skills in this area. However, given the positive attitude of the students toward this issue, these skills can be promoted. Therefore, it is recommended to design and implement sexual health programs for midwifery students.

Background and Objective: The prevalence of snoring and sleepiness increases during pregnancy and affects maternal health and pregnancy outcomes. Therefore, this study was conducted to assess the association between snoring during pregnancy and the risk of preeclampsia. Materials and Methods: This case-control study was performed among 150 pregnant women with preeclampsia and 150 healthy women referred to health centers and academic hospitals of Mashhad, Iran. Data collection tools included the information form regarding demographic characteristics, clinical signs, and laboratory findings. To evaluate snoring and its severity, the related question in Pittsburgh Sleep Quality Index (PSQI) was applied. Statistical analysis of data was performed by independent t-test, Mann-Whitney, chi-square test, and logistic regression model. Results: There was significant association between snoring and preeclampsia (P < 0.001), so that the mean and standard deviation (SD) of snoring (Likert Scale of 0-3) in patients with preeclampsia was 0.6 ± 1.1, and in nonpreeclamptic women was 0.4 ± 0.9. The chance of preeclampsia in women with snoring was 1.73 times more than those without snoring [Odds ratio (OR) = 1.73, confidence interval (CI) 95%: 1.29-2.25]. Conclusion: Snoring is a predicting factor of preeclampsia. Thus, midwives and health workers' attention during pregnancy is recommended.