Search

Background: Safety culture, as a component that improves the quality of safety and health care for neonates, serves as foundation for providing professional and high-quality care by creating positive insight among employees. This study aimed to explore the safety culture concept in neonatal intensive care units (NICUs)., Methods: This convergent parallel mixed-method study included Quantitative, Qualitative, and Integrated parts. In the Quantitative part, the psychometric properties of the Persian version of "Hospital Survey on Patient Safety Culture" were examined among physicians and nurses in NICUs. CFA was performed on the data obtained from 342 participants. The Qualitative section data were collected through in-depth and semi-structured interviews with 24 staff to understand the concept of safety culture. Data were analyzed through the Elo & Kyngäs approach. The interpretation of the results and the convergence of the data was done using the Onwuegbuzie and Teddlie method., Results: The initial CFA showed that the 12-dimensional model did not align well with indices. Subsequently, based on T-values, six heterogeneous items were eliminated. The revised 11-dimensional model consisting of 36 items showed an acceptable fit during the second CFA. In the qualitative part, five main categories of "Constructive interactions", "Management's commitment to neonatal safety", "Organizational supportive climate", "Professional development", and "Planning and implementation of neonatal developmental care" were obtained. The comparison of the results showed that the dimensions of the quantitative part, except for "Overall perceptions of patient safety", were also present in the qualitative part, but they were different in some aspects. New findings in the qualitative study such as "Striving for mutual empowerment", "Constructive criticism in teamwork", "Efficient supervision procedures", "Inexperienced staff' leading" and "Provision of care assistance equipment and facilities" were not found in the dimensions of the quantitative part. The main categories "Acquiring professional competence" and "Planning and implementation of neonatal developmental care" were not align with the dimensions identified in the quantitative study., Conclusion: The findings shed light on previously unexplored aspects of the safety culture concept within the nursing profession, leading to a better understanding and evolution of this concept in Iranian NICUs. The new definition obtained in this study can enhance nursing knowledge on safe care and improve patient safety culture in the NICUs in Iran and globally., (© 2024. The Author(s).)

Treatment-resistant dermatophytosis caused by the members of the Trichophyton mentagrophytes/Trichophyton interdigitale species group (TMTISG) is increasing worldwide. We aimed to determine the prevalence of TMTISG in patients with dermatophytosis in two centers from north of Iran and detect the possible mutations in the squalene epoxidase (SQLE) gene in relevant terbinafine (TRB) resistant pathogenic isolates. From November 2021 to December 2022, 1960 patients suspected to dermatophytosis and referred to two mycology referral laboratories in the north of Iran were included in the study. Identification of all dermatophyte isolates was confirmed by RFLP of rDNA internal transcribed spacer (ITS) regions. Antifungal susceptibility testing against five common antifungals using the CLSI-M38-A3 protocol was performed. The TMTISG isolates resistant to TRB, were further analyzed to determine the possible mutations in the SQLE gene. Totally, 647 cases (33%) were positive for dermatophytosis of which 280 cases (43.3%) were identified as members of TMTISG. These were more frequently isolated from tinea corporis 131 (44.56%) and tinea cruris 116 (39.46%). Of 280 TMTISG isolates, 40 (14.3%) were resistant to TRB (MIC ≥ 4 µg/mL), all found to be T. indotineae in ITS sequencing. In SQLE sequencing 34 (85%) of TRB-resistant isolates had coincident mutations of Phe 397 Leu and Ala 448 Thr whereas four and two isolates had single mutations of Phe 397 Leu and Leu 393 Ser, respectively. Overall, the resistance of Iranian TMTISG isolates to TRB greatly occurred by a mutation of Phe 397 Leu in the SQLE gene as alone or in combination with Ala 448 Thr. Nevertheless, for the occurrence of in vitro resistance, only the presence of Phe 397 Leu mutation seems to be decisive., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Aims: Investigating post-traumatic growth (PTG) in mothers with the experience of having a preterm newborn hospitalized in the NICU requires a valid tool. This study aims to determine the validity and reliability of the Farsi version of the post-traumatic growth inventory (PTGI) in mothers with the experience of having their newborns hospitalized in the NICU., Design: This study was methodological research., Methods: In this study, 250 mothers who had newborns with a history of NICU hospitalization during the last 3 to 12 months and had visited paediatric clinics of the selected hospitals in Tehran with the aim of having their children's condition examined were selected through convenience sampling. The data were collected using a demographic information questionnaire and PTGI. The face validity, the construct validity (confirmatory factor analysis), and the internal consistency reliability of the inventory were measured using SPSS V22 and LISREL V8.8., Results: According to appropriate values for factor analysis fit indices (FI = 0.94, RMSEA = 0.07, IFI = 0.94, NFI = 0.93, RFI = 0.91, NNFI = 0.93, SRMR = 0.07), 21 items and 5 factors were confirmed for this inventory. Furthermore, Cronbach's alpha coefficient of this inventory was measured as α = 0.94., Conclusion: According to favourable psychometric properties, the Farsi version of PTGI is a suitable tool for studying PTG in mothers with the experience of having preterm newborns in the NICU. Using PTGI can help nurses in planning family-centered care interventions to reduce the impact of the mental trauma caused by the preterm newborn's hospitalization in parents., Patient or Public Contribution: Mothers who had newborns with a history of NICU hospitalization during the last 3-12 months., (© 2023 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Background: Safety culture, as an important and influential component of neonatal safety, can lay the ground for the provision of professional and quality care by creating a positive insight among workers. The present study aimed to explain the concept of safety culture and its dimensions from the perspective of the nurses and the physicians working in neonatal intensive care units (NICUs)., Methods: This qualitative directed content analysis study was carried out with 24 NICU physicians and nurses working in Tehran, Iran. These multicenter participants were selected through purposive sampling with maximum diversity in terms of demographic characteristics. The data was collected through in-depth semi-structured interviews and was analyzed using the deductive approach. The COREQ checklist was used for the comprehensive report of this study., Results: The concept of patient safety culture in NICUs included achieving professional development, constructive interactions, organizational supportive climate, management's commitment to neonatal safety, planning and implementation of neonatal developmental care, which are extracted from 5 main categories, 10 generic categories and 21 sub-categories., Conclusion: The dimensions of safety culture include procedures that, if promoted, could improve neonatal safety, reducing harm to neonates' health while expending less financial and human resources. Gaining knowledge of the status of these dimensions in wards and hospitals can give a purposeful direction to promote neonate health and policymaking., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Babaie, Nourian, Atashzadeh-Shoorideh, Manoochehri and Nasiri.)

Aim: This study aimed to determine the effect of the Benson relaxation technique on the severity of symptoms and quality of life in children with irritable bowel syndrome (IBS)., Design: This quasi-experimental study was carried out on children with irritable bowel syndrome in Iran., Method: Sixty children were randomly divided into control and experimental groups. The Benson relaxation technique was implemented for three weeks for experimental group, while the control group only received the typical medical therapy with no special intervention. The questionnaire of Irritable Bowel Syndrome-quality of life-34 (IBS-QOL-34), and Bowel Symptoms Severity and Frequency Scale (BSS-FS) were used for data gathering before and three weeks after the intervention. Data were analyzed using statistics, appropriate parametric and non-parametric tests., Results: According to the results, the experimental group had lower mean scores of qualities of life before the intervention (p < 0.05). The mean score of symptom severity in children with IBS was 13.88 in the experimental group, which changed to 9.83 in the post-test, indicating a significant difference (p < 0.000). The pre-test and post-test mean scores for quality of life in this group were 118.94 and 102.77, respectively, indicating a significant difference (P < 0.001)., Conclusion: The Benson relaxation technique can be a non-pharmacological solution to reduce the severity of symptoms and improve the quality of life of children with IBS., Implication to Practice: This technique is supposed to contribute as a further intervention in clinical contexts., (© 2022. The Author(s).)

Aim: This study aimed to assess patient-safety principles in ICUs., Design: This is a descriptive-comparative study., Methods: The research environment includes ICUs of hospitals affiliated to the two universities of medical sciences in Tehran. Sampling was done by census using Time and Event Sampling methods. Research instrument was "Patient Safety Principles Checklist". Data analysis was performed using SPSS-20 and descriptive-inferential statistics with a significance level of 0.05., Results: There is no significant difference (p-value = .15) in the level of observance of patient-safety principles in two university-affiliated hospitals A (133.26 ± 9.14) and B (128.16 ± 18.01). Evaluation of the mean scores obtained in each dimension and in each of the ICUs was showed that only in dimension No.3 the difference was significant (F[68,2] = 5.20, p-value = .008) and in the AICUs (16.13 ± 1.8) (p-value = .04), it was significantly lower than other ICUs. Identifying risk factors for the patient's immunity reduces the side effects of patient care., (© 2022 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Introduction: Treatment team charged to help patients and their family making decision about donate organs in the final stage of life. Hence, their knowledge and attitude is important to plan of increasing the rate of organ donation., Materials and Methods: About 150 nurses recruited in this cross-sectional study randomly. After taking informed consent, questionnaires were filled. The data collection tool was a multipart questionnaire including demographic information, 18 questions about attitude and practice and 15 question about knowledge toward organ donation. Data were analyzed by SPSS software using K-squire, Pearson correlation test, T-test, variance analyze on 95% confidence interval., Results: Most of participants (76%) were 25-44 years old. About 81.3% of them were female (n=122). The attitude average score between males and females was 85.25±35.61 and 70.37±46.53, respectively. The practice average score in females was 34.43±47.71 and between males was 29.63±46.53. The knowledge average scores were 50.60±16.19 and 56.54±17.48 for two groups (p>0.05). The knowledge average scores between different age groups was significant (p<0.05). There was a direct and significant relation between attitude and practice (r=+0.33, p<0.05), attitude and Factors influencing attitude and practice (r=0.866, p<0.05), but the relation between attitude and knowledge was indirect and significant (r=-0.183, p<0.05)., Conclusions: Since the medical team are most important adviser for promote activities related to organ donation, it seems that educational curriculum and facilities should applied to enhance attitude and behavior favorable change of personnel towards this issue.

Many snake venoms comprise different factors, which can either promote or inhibit the blood coagulation pathway. Coagulation disorders and hemorrhage belong to the most prominent features of bites of the many vipers. A number of these factors interact with components of the human blood coagulation. This study is focused on the effect of Echis carinatus snake venom on blood coagulation pathway. Anticoagulant factors were purified from the Iranian Echis carinatus venom by two steps: gel filtration (Sephadex G-75) and ion-exchange (DEAE-Sephadex) chromatography, in order to study the anticoagulant effect of crude venom and their fractions. The prothrombin time was estimated on human plasma for each fraction. Our results showed that protrombin time value was increase from 13.4 s to 170 s for F2C and to 280 s for F2D. Our study showed that these fractions of the venom delay the prothrombine time and thus can be considered as anticoagulant factors. They were shown to exhibit proteolytic activity. The molecular weights of these anticoagulants (F2C, F2D) were estimated by SDS/PAGE electrophoresis. F2C comprises two protein bands with molecular weights of 50 and 79 kDa and F2D a single band with a molecular weight of 42 kDa.