The effect of polyethylene cover intervention on ocular surface disorder of intensive care unit patients: a systematic review and meta-analysis.

BACKGROUND: Polyethylene covers have been proven to be effective in protecting the eyes in patients with decreased or disappeared blink reflexes, but their advantages compared to other conventional methods are still unclear. This systematic review and meta-analysis study aimed to elucidate the impact of polyethylene covers in the prevention of ocular surface disease (OSD) in patients admitted to the intensive care unit (ICU). METHODS: We searched the Scopus, PubMed, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) databases to identify randomized controlled trial studies. This study followed the PRISMA guidelines and used the Cochrane Collaboration tool to assess the risk of bias. RESULTS: The findings were expressed as risk ratio (RR) with 95% confidence intervals. The incidence of OSD in the polyethylene cover group was lower than that in the eye drops group (RR = 0.27; 95% CI (0.07, 1.09), P = 0.07) and adhesive tape group (RR = 0.11, 95%CI (0.04, 0.31), P < 0:0001) but the polyethylene cover group showed no significant difference compared to the eye gel group (RR = 0.79, 95%CI (0.18, 3.51), P = 0.76) and the eye ointment group (RR = 0.85; 95% CI (0.36, 1.99), P = 0.71). CONCLUSION: This study showed that polyethylene covers, eye gels, and eye ointments had an equal effect on preventing OSD in ICU patients, and eye drops and adhesive tapes were relatively less effective. However, other intervention methods had not been compared due to the small number of articles. Hence, further studies should assess the available methods to choose the best practical method.

Nursing students' ethical challenges in the clinical settings: A mixed-methods study.

BACKGROUND: Nursing students experience ethical conflicts and challenges during their clinical education. These may lead to moral distress and disturb the learning process. OBJECTIVES: This study aimed to explore and to evaluate the nursing students' ethical challenges in the clinical settings in Iran. RESEARCH DESIGN: This was a mixed-methods study with an exploratory sequential design. PARTICIPANTS AND RESEARCH CONTEXT: A total of 37 and 120 Iranian nursing students participated in the qualitative and quantitative phases, respectively. ETHICAL CONSIDERATIONS: The ethical committee of Kerman University of Medical Sciences, Iran, approved the protocol of the study. FINDINGS: Three main categories were extracted from qualitative data including Low attention of nurses to the patients' preferences; Lack of authority; and Inadequate support. A total of 97% of the students had more than one ethical challenge in clinical settings and 48% of them stated that their challenges did not resolve. The total score of perceived ethical challenges was 62.03 ± 9.17, which was moderate. The highest mean score related to the "Low attention of nurses to the patients' preferences" subscale. DISCUSSION: The finding confirmed most of the existing results of other international researches about the frequency and kinds of baccalaureate nursing students' ethical challenges. CONCLUSION: Identifying student ethical challenges helps teachers to manage their clinical learning process better. This study may provide a view for the nurses, clinical educators, and managers toward nursing students' ethical challenges and their impact on nursing students' clinical experiences.

The effect of recommended Azkar on anxiety, stress, and depression in families of patients undergoing open heart surgery.

INTRODUCTION: Admission of a family member to hospital would cause stress on other family members also. One of the most stressful treatment interventions imposing high level of anxiety to the families of patients is when the patients are undergoing a surgery, especially a cardiac surgery. So, we decided to investigate whether recommended Azkar could reduce stress, anxiety, and depression in families of the patients. MATERIALS AND METHODS: This study is a quasi-experimental study conducted on 120 immediate relatives of patients undergoing a cardiac surgery. Families of patients undergoing open heart surgery were randomly divided into two groups of study and control. The Depression, Anxiety, and Stress Scales (DASS 21) questionnaires were completed by both groups. Then, some explanations about how to use recommended prayers were given to the study group, and an hour later, the questionnaires were completed again. The data were analyzed by SPSS. P < 0.05 were considered significant. RESULTS: Stress, anxiety, and depression showed a significant difference in the study group before and after intervention. Similarly, there was a significant difference in the mean scores of anxiety, stress, and depression in the study and control groups after intervention. CONCLUSIONS: Findings of the present study showed that recommended religious prayers can significantly reduce anxiety, depression, and stress of families of the patients undergoing open heart surgery.

The effects of supine and prone positions on oxygenation in premature infants undergoing mechanical ventilation.

BACKGROUND: Since the use of high concentrations of oxygen in infants may lead to chronic lung problems, using proper methods of care in infants under mechanical ventilation is one of the most important measures in NICU. This study aimed to investigate the effects of prone and supine positions on oxygenation (SPO(2)) in premature infants under mechanical ventilation and comparing infants' oxygenation in the two positions. METHODS: In across over non randomized clinical trial study, 32 preterm infants under mechanical ventilation who had inclusion criteria were enrolled in simple convenient method. Firstly, they were placed in supine position for 120 minutes and further in prone position for 120 minutes .Their SPO(2) were monitored by pulse oximeter continuously and was recorded every minute. Data analysis was done using Software SPSS(15) by ANOVA test and post hoc test. RESULTS: The data showed that during 120 minutes of exposure of infants in each position there were no significant changes in SPO(2). In addition, the SPO(2) levels in the prone position were significantly higher than the SPO(2) levels in the supine position from 15(th) minute to 120(th) minute (to the end). CONCLUSIONS: Neonatal positioning in prone position is a simple, non-invasive, and free of charge method that could lead to improve oxygenation in infants undergoing mechanical ventilation.