Moral Distress and Related Factors among Nurses Working in the Emergency Departments: A Cross-sectional Study.

Objective: The present study aimed to determine the prevalence and severity of moral distress (MD) and its associated factors among emergency department nurses. Methods: This cross-sectional study was conducted in 2023 on 172 nurses from the emergency departments of medical training centers affiliated with Mazandaran University of Medical Sciences. The census method was used to collect the data, which included demographic variables and Corley's MD questionnaire. The Data were analyzed using SPSS software (version 22), using an independent T-test, analysis of variance (ANOVA), and multiple regressions. Results: Out of 172 nurses, 60.5% were women, with an average age of 32.52±6.88 years. The results demonstrated an average MD score of 69.73±25.68. In terms of frequency and intensity, around 53.5% of the participants experienced MD at a low level (0-72), while the remaining 46.5% reported experiencing it at a medium level (14-73). A significant association was found between MD and age (p=0.037), workplace hospital (p=0.005), and history of mental disorders (p=0.005). Furthermore, linear regression analysis revealed a statistically significant association between MD, marital status, and occupational type (p<0.05). Conclusion: The results showed that nurses had low to moderate levels of MD. Several factors, including age, history of mental disorders, marital status, employment type, workplace hospital, and education, were associated with the overall MD score. To reduce MD and its negative effects on nurses, it is necessary to address these factors and develop an effective strategy for identifying and managing MD to improve nursing care quality.

Competencies of charge nurses: a systematic review and thematic synthesis.

OBJECTIVE: To determine the competencies of charge nurses. METHODS: The systematic review and thematic synthesis study was done at Iran from1 Apr 2018 to 31 Jul 2018. Five electronic bibliographic database (Science Direct, Pro Quest, Scopus, Pub-Med, Scientific Information Database) were systematically searched for relevant literature published from 1980 to 2018. Content analysis was done to categorise competency of charge nurses. RESULTS: Of the 1285 articles, 24(1.86%) were reviewed. Through thematic synthesis, six themes identified were self-management, others' management, clinical competency, conceptual-cognitive competency, professional-legal competency and competency in communication. There is need to improve knowledge and skills in the domains of management, leadership, communication and perceptual/cognitive competency. CONCLUSIONS: The findings may help nurse administrators and nurse directors in designing training programmes for charge nurses who could improve their competencies.

Clinical findings leading to the diagnosis of sepsis in neonates hospitalized in Imam Khomeini and Bu Ali hospitals, Sari, Iran: 2011-2012.

BACKGROUND: One of the important diseases in neonatal period is sepsis. Clinical sign and symptoms in addition to lab tests are the most important way to accurate diagnosis and prevention of mortality. This study was conducted with the aim of determining the most clinical sign and symptoms which leading to diagnosis of sepsis. MATERIALS & METHODS: This is a descriptive cross-sectional study. The medical records of patients hospitalized in hospitals of Mazandaran University of Medical Sciences during 2011-2012 were reviewed. Variables were age, sex, birth and admission weight, clinical sign and symptoms, methods of delivery, admission and discharge condition, discharge status, the time elapsed between showing the symptom and admission to hospital, gestational age and the result of cultures. The data were recorded in a checklist and analyzed with SPSS and descriptive statistics. RESULTS: finding showed that 120 patients discharged during period of study with diagnosis of sepsis. Discharged status of 27 (%22/5) were expired. Median age was 1 day with 8 hours SD, length of stay were 12±1 days, gestational age was34±3 weeks and median birth weight was 2477±977 grams. The median time elapsed between showing the symptom and admission to hospital was 38±31 hours. Blood culture in 10 (%8/3) and urine culture in 8 (%7/6) patients were positive. None of patients have positive lumbar puncture culture. The frequent sign and symptpms in patients were respiratory distress, poor feeding and lethargy. CONCLUSION: Early diagnosis of neonatal sepsis is not possible only by specific laboratory exams. Clinical sign and symptoms can help us to prediction and diagnosis of neonatal sepsis. Results of this research revealed that it is not clear which one of manifestations was started first or the second because of medical history sheets don't show this process.

Association between awareness of patient rights and patient's education, seeing bill, and age: a cross-sectional study.

BACKGROUND: Considering the controversial results of previous reports on awareness of bill of patients' rights in different regions, as well as the fact that no report is available on the awareness of patients of their rights in teaching hospitals of Sari, we conducted the present study. MATERIALS & METHODS: This is a cross-sectional Study conducted in teaching hospitals of Sari in 2011. The study population consisted of 336 patients recruited from 4 hospitals affiliated with Mazandaran University of Medical Sciences in Sari, through calculating the selection quota of each hospital. Data were collected through face-to-face interview on discharge, using a two-section questionnaire based on the bill of patient rights and with verified reliability and validity. Data analysis was accomplished on SPSS soft- ware version 10. RESULTS: 55.4% of patients were women and 44.6% were men. The patients' mean age was 40.93 ± 15.04 years and the mean length of stay was 4.6 ± 3.34 days. Most patients had elementary education (36%) or were illiterate (25%). The majority (63.4%) had not seen the bill of patients' rights. 58.9% had poor knowledge, 12% had intermediate knowledge, and 29.1% had good knowledge. As for the articles of the bill, the poorest awareness correlated to the 9th article (the right to participate or refrain from participating in research). We found a significant relationship between awareness of the bill, and the patient's education, seeing the bill, and age (p < 0.0005). CONCLUSION: The results of the present study indicate that patients are not sufficiently aware of their rights, and this problem requires comprehensive planning to be resolved.