Study of readiness and performance of nurses in evaluating clinical care and processes of care and nursing.

Background: Clinical care and nursing skills are important issues that can influence the efficacy of treatment, the health of patients, and medical errors. The aim of this study was to investigate the readiness of medical staff in the field of effectiveness and evaluation of clinical care and nursing skills. Materials and methods: This descriptive, cross-sectional study was performed on 99 medical staff working in hospitals from August 2020 to December 2021. The instrument used was a checklist for the effectiveness and evaluation of clinical care based on the findings of the nursing reports. Data were analyzed by statistical software. Results: The mean age of nurses was 37.5 years. Among the participants, 16.3% were male and 85.7% were female; 56.6% of nurses had completed clinical care. The overall performance of nurses in drug-related care and nursing processes was observed to be acceptable. Nurses were successful in performing many aspects of the nursing processes of repulsion, absorption, and dressing and showed good preparation. In relation to gavage, a high percentage of nurses performed the procedure well. However, in some cases, such as medication-related care, handwashing, and the use of personal protective equipment, where there is a possibility of touching the blood or other body fluids of the patients, the performance of nurses was moderate. Conclusion: The findings of this research demonstrated that there are limitations, strengths, and weaknesses in terms of some aspects such as medication, care and nursing processes, compliance with standards, and infection control, which can be considered to improve the performance of nurses in the future.

Highly Stable Low-Cost Electrochemical Gas Sensor with an Alcohol-Tolerant N,S-Codoped Non-Precious Metal Catalyst Air Cathode.

The emerging applications of electrochemical gas sensors (EGSs) in Internet of Things-enabled smart city and personal health electronics bring out a new challenge for common EGSs, such as alcohol fuel cell sensors (AFCSs) to reduce the dependence on a pricy Pt catalyst. Here, for the first time, we propose a low-cost novel N,S-codoped metal catalyst (FeNSC) to accelerate oxygen reduction reaction (ORR) and replace the Pt catalyst in the cathode of an AFCS. The optimal FeNSC shows high ORR activity, stability, and alcohol tolerance. Furthermore, the FeNSC-based AFCS not only demonstrates excellent linearity, low detection limit, high stability, and superior sensitivity to that of the commercial Pt/C-based AFCS but also outperforms commercial Pt/C-based AFCS in the exposed cell regarding great linearity, high sensitivity, and great stability. Such a promising sensor performance not just proves the concept of the FeNSC-based ACFS but enlightens the next-generation designs toward low-cost, highly sensitive, and durable EGSs.

Tracheostomy in Patients Who Need Mechanical Ventilation: Early or Late? Surgical or Percutaneous? A Prospective Study in Iran.

Tracheostomy can be performed surgically or by percutaneous (percutaneous dilatory tracheostomy, PDT) methods, and it may be used early or late. In a 3-month follow-up, all patients who underwent tracheostomy in Semnan in 2013 were evaluated for complications of tracheostomy considering the method used and the timing of operation. A total of 55 patients underwent tracheostomy (26 cases surgery, 29 cases PDT, 30 cases early, and 25 cases late based on 14 days reference). The mean durations of operation were 19.19 ± 5.78 min in the surgery method and 4.7 ± 2.42 min in the PDT method (P < 0.001). The mean durations of the need for ventilator after the tracheostomy were 10.7 ± 9.25 and 18.6 ± 14.39 days in early and late tracheostomy, respectively (P = 0.024). The mean intensive care unit (ICU) stay were 12.70 ± 10.24 and 23.44 ± 18.49 days (P = 0.014) and the mean hospital stay were 16.04 ± 10.88 and 23.48 ± 18.47 days, respectively (P = 0.100). Short-term complications were observed in six cases (10.09 %) in the surgery group, including emphysema (two), bleeding (two), wound infection (one), and clot formation inside the tube (one). Only one complication (bleeding) occurred in one case in the PDT group. After 3 months, 21 patients survived. Compared with surgery, the most important advantage of the PDT method was its shorter duration of surgery. Nearly half of the patients underwent tracheostomy late, while the majority of the patients in the late group were referred from internal ICU. No major and minor complications were noted during the procedure, as well as no tracheostomy-related deaths were observed. Early tracheostomy was shown to be superior to late, reducing the time of mechanical ventilation and ICU or hospital stay.