Assessing Evidence-Based Practice in Operating Room Nursing Students: A Cross-Sectional Study in the Southwest of Iran.

Evidence-based practice (EBP) is a clinical decision-making process that is grounded in the utilization of the most reliable and up-to-date evidence. It involves utilizing resources and evidence to enhance patient management. The application of evidence-based decisions in patient care and education is of utmost importance in the performance of health sciences students. However, the emphasis on this concept among operating room nursing students has been lacking. Hence, the objective of this research is to assess the implementation of evidence-based practice among operating room nursing students studying in the operating room department at the Shiraz University of Medical Sciences in Iran. The study follows a descriptive, cross-sectional design, with a sample of 148 operating room nursing students selected through census sampling based on the student list. After obtaining informed consent, participants completed a demographic information form and the Rubin-Parrish evidence-based practice questionnaire. The data that were gathered underwent analysis through the utilization of SPSS version 22 software, employing descriptive statistics, T-tests, and Pearson correlation coefficient tests. The results revealed that the overall average score of evidence-based practice among the students exceeded the standard scores (172.66 ± 14.74). There was a significant association between the evidence-based practice score and prior familiarity with evidence-based practice, interest in the field of study, research experience, intention to participate in the Master's exam, and the participants' grade point average (GPA) (p < 0.05). These findings indicate that operating room nursing students displayed an average level of evidence-based practice, emphasizing the need for effective plans and strategies to improve their performance. Addressing the identified factors from this study becomes crucial in this regard.

Comparison of the effects of virtual training by serious game and lecture on operating room novices' knowledge and performance about surgical instruments setup: a multi-center, two-arm study.

BACKGROUND: Game-based training is increasingly implemented in different nursing fields, as it allows students to learn experientially, with the flexibility to regulate their training based on their personal progresses and abilities. This study aimed to compare the effects of virtual training by the "Playing with Surgical Instruments (PlaSurIn)" game and the lecture on the surgical instruments setup knowledge and performance of Operating Room (OR) novices. METHODS: This study was conducted on 51 s-semester undergraduate OR technology students taking the course "An Introduction to Surgical Instruments and Equipment." An additional virtual training session was held via a learning management system using two different methods. The students of the Game Training Group (GTG, n = 27) played individually with the "PlaSurIn" game during a week, while the students of the Lecture Training Group (LTG, n = 24) received the lecture-based training during a week. To measure knowledge, all the students participated in a theoretical test with 10 multiple-choice questions before and immediately after the training. They also participated in an Objective Structured Clinical Examination (OSCE) after the training, and their performance was evaluated by the remained time for setup completion and the scores, errors, and bonuses. RESULTS: The mean score of the theoretical test was significantly higher in the GTG than in the LTG after the training (p = 0.040). Additionally, the GTG participants had higher scores (p = 0.016), fewer errors (p = 0.001), and higher bonuses (p = 0.011) compared to the LTG ones. The remained time for setup completion was also significantly longer in the GTG than in the LTG (p < 0.001). CONCLUSION: Virtual training by "PlaSurIn" was superior to the lecture-based method for the enhancement of surgical instruments setup knowledge and performance amongst OR novices.

EFFECT OF PANRETINAL PHOTOCOAGULATION ON CORNEAL SENSATION AND TEAR FUNCTION IN PATIENTS WITH DIABETIC RETINOPATHY.

PURPOSE: To evaluate the early effects of panretinal photocoagulation (PRP) on corneal sensation and dry eye signs in patients with diabetic retinopathy. METHODS: Fifty patients with Type 2 diabetes mellitus and very severe nonproliferative or non-high-risk proliferative diabetic retinopathy who required PRP for the treatment of their retinal condition were enrolled. All patients were treated using a pattern PRP device. Esthesiometry, tear breakup time test, Schirmer test, and corneal staining pattern were evaluated at baseline and 2 months after the last session of PRP. RESULTS: Data from 88 eyes of 50 patients (41 right eyes and 47 left eyes) were analyzed. The mean tear breakup time test (right eyes) was decreased from 9.51 at baseline to 7.66 seconds after PRP (P < 0.001). The post-PRP eyes showed more advanced grades of corneal staining than pre-PRP assessment (P < 0.001). The average value of Schirmer test was 14.39 versus 12.29 mm (without anesthesia; P < 0.001) and 8.17 versus 7.15 mm (with anesthesia, P < 0.001) for baseline versus post-PRP measurements, respectively. The corneal sensation also showed decrease after laser therapy (4.93 versus 4.31 cm; P < 0.001). CONCLUSION: This study demonstrates that decreased corneal sensation and signs of dry eye are more common immediately after PRP for diabetic retinopathy. These conditions should be discussed with the patient preoperatively and managed postoperatively.

Investigation of the Role of Complementary Medicine on Anxiety of Patients Before and After Surgery: A Review Study.

Every year millions of patients undergo surgery worldwide. Anxiety is a common pre- and postoperative problem. Nonpharmacologic anxiety control has been demonstrated to be more suitable in patients. The objective of this study was to apprise the evidence of the effect of various complementary therapies on pre- and postoperative anxiety among patients. A comprehensive literature search was made on Web of Science, Scopus, Cochrane, PubMed Irandoc, SID Science, ScienceDirect, Ovid, Mag Iran, and Google Scholar for original research studies published between 1980 and 2019. Original articles that reported the effect of complementary therapies in patients undergoing surgery were included. Ninety-six studies were analyzed. All of the studies have documented the effects of complementary therapies on improving pre- and postoperative outcomes of patients. Although methods varied considerably, most of the studies included in this review reported positive results. Therefore, there is some evidence that complementary therapies can lead to positive pre- and postoperative outcomes. Therefore, the efficiency and use of complementary medicine, along with the use of therapeutic techniques in classical medicine, can provide a new model for reducing anxiety before and after surgery. It is recommended that nurses conduct additional reviews or clinical studies so that effective approaches to integrated medical care can be developed and patients' health enhanced.

Should Parents Allow Their Children Use Smartphones and Tablets? The Issue of Screen Time for Recreational Activities.

Previous research has shown that children are more vulnerable to the adverse effects of radiofrequency electromagnetic fields (RF-EMFs) and blue light emitted from digital screens compared to healthy adults. This paper presents the findings of a cross-sectional study conducted in Yasuj, Iran, to investigate the screen time habits of children and adolescents and its potential impact on their health. A total of 63 participants, including 44 boys and 19 girls, were randomly selected for the study. The results showed that the average daily screen time for the children was 87.38 minutes, with a standard deviation of 49.58. When examining the specific purposes of screen time, it was found that the children spent an average of 17.54 minutes per day on screens for school assignments, 70 minutes per day for recreational purposes, and 23.41 minutes per day for contacting family, friends, and relatives. Our study highlights that a significant portion of the children's screen time was allocated to recreational activities. We observed some differences in screen time between girls and boys. Boys had a slightly higher overall daily screen time, primarily driven by more recreational screen time. However, girls spent slightly more time on screens for school assignments. The screen time for social interactions was similar for both genders. Our findings on the cognitive performance of children with different levels of screen time will be published in a separate paper.

How Do Different Physical Stressors' Affect the Mercury Release from Dental Amalgam Fillings and Microleakage? A Systematic Review.

Background: Approximately 50% of dental amalgam is elemental mercury by weight. Accumulating body of evidence now shows that not only static magnetic fields (SMF) but both ionizing and non-ionizing electromagnetic radiations can increase the rate of mercury release from dental amalgam fillings. Iranian scientists firstly addressed this issue in 2008 but more than 10 years later, it became viral worldwide. Objective: This review was aimed at evaluating available data on the magnitude of the effects of different physical stressors (excluding chewing and brushing) on the release of toxic mercury from dental amalgam fillings and microleakage. Material and Methods: The papers reviewed in this study were searched from PubMed, Google Scholar, and Scopus (up to 1 December 2019). The keywords were identified from our initial research matching them with those existing on the database of Medical Subject Headings (MeSH). The non-English papers and other types of articles were not included in this review. Results: Our review shows that exposure to static magnetic fields (SMF) such as those generated by MRI, electromagnetic fields (EMF) such as those produced by mobile phones; ionizing electromagnetic radiations such as X-rays and non- Ionizing electromagnetic radiation such as lasers and light cure devices can significantly increase the release of mercury from dental amalgam restorations and/or cause microleakage. Conclusion: The results of this review show that a wide variety of physical stressors ranging from non-ionizing electromagnetic fields to ionizing radiations can significantly accelerate the release of mercury from amalgam and cause microleakage.

An overview of the comparison of inhalation aromatherapy on emotional distress of female and male patients in preoperative period.

OBJECTIVES: Many patients experience anxiety and stress before surgery. Anxiety is also different in men and women so that the prevalence of anxiety disorders in women is higher than men. The present study aimed to compare the effect of inhalation aromatherapy on emotional distress of men and women before surgery. METHODS: This study conducted as a randomized, single blind, placebo-controlled, prospective and clinical trial. It was performed in hospitals affiliated to Shiraz University of Medical Sciences. 90 patients were selected as candidates for surgery and were divided into two intervention groups and one control group. Patients completed the State-Trait Anxiety Inventory questionnaire before the intervention. Patients completed the State-Trait Anxiety Inventory questionnaire (STAI) after 20 min of intervention. Then the data were analyzed using SPSS software, version 16. The significance level in all testes was set at <0.05. RESULTS: Relatively severe anxiety was not observed in men after intervention with lavender and spring orange. In women, relatively severe anxiety was not observed after the intervention with lavender, but in the spring orange group, only in 6.7% of people, relatively severe anxiety and traits were observed, which has decreased compared to before the intervention. In addition, the severity of anxiety in women in the control group increased after placebo intervention (p<0.05). CONCLUSIONS: The results showed that inhalation of Citrus aurantium and lavender aroma reduces anxiety in male and female patients.

Effect of topical povidone-iodine 10% plus levofloxacin 0.5% 1 hour before cataract surgery in eliminating perioperative conjunctival flora: randomized clinical trial.

PURPOSE: To evaluate the effect of a single administration of topical povidone-iodine (PVI) 10% plus levofloxacin 0.5% at 1 hour before cataract surgery on perioperative elimination rate of conjunctival flora. SETTING: Poostchi Ophthalmology Research Center, Shiraz, Iran. DESIGN: Randomized controlled trial. METHOD: Patients who required cataract surgery were randomly assigned to 1 of 2 groups: intervention (administration of PVI 10% plus levofloxacin 0.5% at 1 hour preoperatively) or control. The patients in both groups received PVI just before the operation. Conjunctival cultures were obtained using thioglycollate broth at 4 timepoints: T1, before intervention; T2, before the second application of PVI; T3, 3 minutes after the second administration of PVI; and T4, just postoperatively. RESULTS: The study comprised 142 patients. The comparative rates of positive cultures in the intervention vs control groups were as follows: T1 (70.4% vs 73.2%, P = .709); T2 (15.5% vs 71.8%, P < .001); T3 (7.0% vs 19.7%, P = .027); and T4 (5.6% vs 4.2%, P = .698). Coagulase-negative Staphylococci was the most common isolated microorganism. CONCLUSIONS: Results showed that a single adjuvant application of PVI 10% plus levofloxacin 0.5% eyedrops at 1 hour before operation leads to a further increase in the rate of sterile conjunctiva just preoperatively.

"Playing with Surgical Instruments (PlaSurIn)" game to train operating room novices how to set up basic surgical instruments: A validation study.

BACKGROUND: Game-based training has been considered as an alternative modality to traditional training in different perioperative nursing fields. OBJECTIVES: To describe the adaptation and validation process of "Playing with Tweezers", a Portuguese game developed for novices to set up basic surgical instruments on the Mayo stand or a back table. DESIGN: A validation study with three phases of translation, reconciliation, and evaluation (face, content, and construct validity). SETTINGS: Several medical universities in Iran. PARTICIPANTS: Twelve students in a pilot translation test, 18 experts in the reconciliation phase, 20 experts in the face and content validity stages, and 120 students (72 novices, 26 intermediates, and 22 experts) in the construct validity stage. METHODS: Following "forward-backward" translation from Portuguese to English, the English version of the game was appraised in the reconciliation phase using a 57-item questionnaire. To test face and content validity of the final version of the game, a 30-item questionnaire addressing different aspects of the game was completed. The students' game performance (remained time for game completion, obtained score, and error) was compared to assess the construct validity. RESULTS: Minor differences were detected and resolved during the translation process. The English version of the game was reconciled in two sequential steps, and the final game called "Playing with Surgical Instruments (PlaSurIn)" was developed. All the items regarding the face validity received 80-100% of positive responses. Moreover, regarding the content validity, all of the evaluated items obtained a content validity index of 0.90-1.0. Compared to the novices, the experts and intermediates received higher scores (p < 0.001 in two cases) and fewer errors (p < 0.001, p = 0.007). The remained time for game completion was significantly longer for experts than the novices (p = 0.011). CONCLUSIONS: The "PlaSurIn", as a virtual training strategy, can prepare novices to set up basic surgical instruments.

Bipolar loop device versus bipolar diathermy for tonsillectomy: A pilot randomized controlled trial.

OBJECTIVE: Tonsillectomy is one of the most common surgeries performed in the pediatric population. Although different forms of instruments and various methods are used to perform tonsillectomy, none of them is still recognized as the best global technique. This study aimed to compare the outcomes of the new Bipolar Loop tonsillectomy versus bipolar diathermy technique. METHODS: This study is a pilot randomized clinical trial and was conducted on 40 pediatric patients who were the candidate of tonsillectomy. Patients were divided into two groups of Bipolar Loop or bipolar diathermy. Operation time, intraoperative bleeding, tonsillar fossa wound, postoperative complications, and duration of return to normal diet were evaluated in the current study. RESULTS: In both of the Bipolar Loop and bipolar diathermy groups, no significant difference was found in terms of sex, age, and weight. The average amount of the operative time, intra-operative blood loss, and postoperative pain loss were significantly less in the Bipolar Loop group (P < .001). In addition, the tonsillar fossa wound healing scores were significantly better (on the 14th day, P = 0.009). However, there was no significant difference between the two groups in terms of postoperative bleeding, duration of return to a normal diet, and postoperative symptoms of fever, otalgia, or voice change between the groups. CONCLUSION: The study showed that blood loss and postoperative pain through day 7 were significantly less in the Bipolar Loop group. Tonsillectomy with Bipolar Loop can be recommended as one of the methods for tonsillectomy, especially in pediatric patients.

The potential beneficial effects of education and familiarity with cesarean section procedure and the operating room environment on promotion of anxiety and pain intensity: A randomized controlled clinical trial.

BACKGROUND: Anxiety before and pain intensity after cesarean section is among the factors that should be taken into consideration among the candidates for cesarean section. The present study aimed to investigate the effect of familiarity with cesarean section and the operating room environment on anxiety and pain intensity among the mothers undergoing cesarean section. METHODS: This clinical trial was conducted on 80 women referred to the hospitals affiliated to Shiraz University of Medical Sciences for cesarean section in 2018. The participants were randomly divided into a control (n = 40) and an intervention group (n = 40). The intervention group took part in four educational sessions, while the control group received the hospital's routine care. The Beck Anxiety Inventory was completed by the two groups before and after the intervention. The McGill Pain Questionnaire was also filled out by the two groups in the ward after the cesarean section. After all, the data were entered into the SPSS software, version 21, and were analyzed using independent t-test and ANCOVA. RESULTS: The results showed no significant difference between the two groups regarding the mean score of anxiety prior to the intervention. After the intervention, the mean score of anxiety was 7.98 ± 3.77 in the intervention group and 19.70 ± 6.45 in the control group, and the difference was statistically significant (P < 0.0001). Indeed, the mean intensity of pain was 43.98 ± 7.63 in the intervention group and 57.75 ± 10.69 in the control group after the intervention, and the difference was statistically significant (P < 0.017). CONCLUSION: The patients' familiarity with cesarean section and the operating room environment caused a decline in the anxiety level prior to cesarean section as well as a decrease in the score of pain after the operation. Hence, midwives and nurses have to play effective roles in decreasing pregnant women's anxiety and pain through identification of strategies for empowering them and managing their worries.

An evaluation of the elements of internal medicine physiopathology curriculum in general practice based on the perspectives of faculty members of Shiraz University of Medical Sciences.

INTRODUCTION: An evaluation of the curriculum elements can be recognized as a necessity in curriculum dynamic and improvement. This study aimed at evaluating five main elements of a physiopathology curriculum in internal medicine (objectives, content, methods, evaluation, and management). METHOD: The present study is of a descriptive-analytical type, and the studypopulation consisted of a total of 48 faculty members of internal medicine physiopathology departmentat Shiraz University of Medical Sciences. Participants wereselected using Cochran's sample size formula andthrough simple random sampling.Thedatawere collected using a 58-item questionnaire devised by the researcher, usingcurriculum planning experts. Face and content validity of the scale were obtained throughexpert views and modifications provided by 10 professors and experts in medical curriculum evaluation. Also, research reliability was calculated using Alpha Cronbachto be 0.99. Reliability value and coefficient was acceptable.Moreover, One-sample t-test, Independent t-test and one-way ANOVA were used for data analysis. RESULTS: Based on the faculty members' views, of the five curriculum elements, objectives and content were in relatively good conditions (at an average level) while other elements including method, evaluation and management were in poor conditions (lower than average). According to results oftwo-way ANOVA, there wasa significant relationship between faculty members with various work experiencein terms of curriculum evaluation. CONCLUSION: According to research findings, a comparative examination of the curriculum elements and their characteristics in physiopathology course can be conducted, resulting in identification of curriculum weaknesses and their pitfalls. Also, with regard to teaching, evaluation, management methods, weak and strong pointsof the course,efficiency, and effectiveness of the elements were identified.