The effect of the clinical supervision model on nursing internship students' nursing process-based performance: an experimental study.

BACKGROUND: The nursing process is a systematic method for identifying the patient's problems and planning to resolve them. It is also a crucial pillar of high-quality nursing care. Nursing internship students may lack the necessary skills to implement the nursing process due to the increased independence, the absence of constant professorial supervision, and limited experience. The clinical supervision model is a method of clinical education that bridges the gap between theory and practice. OBJECTIVE: This study was conducted to investigate the impact of the clinical supervision model on the performance of nursing internship students in each of the five stages of the nursing process, as well as overall. METHOD: This experimental study was conducted in 2022. The 70 eligible internship students were conveniently selected and randomly assigned to either an intervention or a control group. In the present study, the clinical supervision model was implemented for the intervention group, while the control group received routine supervision. This was carried out over six sessions in three months. The data collection was conducted using a researcher-developed checklist of nursing process-based performance in both groups. Moreover, the Manchester questionnaire was used to evaluate the model in the intervention group. The variables considered as confounding factors included age, gender, marital status, number of monthly shifts, and grades of the nursing process credit completed in the third semester. SPSS version 16 software, descriptive statistics (frequency distribution, percentage, mean, and standard deviation), and analytical statistics (independent t-test, chi square, repeated measures Anova and LSD) were used to analyze the data. RESULTS: Intergroup analysis revealed that there was no significant difference between the scores of nursing process steps and the total score before the intervention in the control and intervention groups, as well as in baseline characteristics (P > 0.05). According to the intragroup analysis, the intervention group showed a significant increase in both the total scores and scores of nursing process steps over time (P < 0.001), whereas the control group exhibited contradictory results (P > 0.05). Finally, the "P-Value Intervention" demonstrated the effectiveness of this training model in improving the performance of the intervention group based on the nursing process compared to the control group. The mean score of the Manchester questionnaire in the intervention group was 136.74, indicating the high impact of implementing the clinical supervision model in the intervention group. CONCLUSION: The results indicated that the implementation of the clinical supervision model led to improved utilization of the nursing process by nursing internship students at all stages. Therefore, it is recommended that nurse educators utilize the clinical supervision model by providing feedback on errors in action during supervision sessions to enhance the quality of nursing care provided by nursing internship students and improve patient safety in clinical environment.

Effect of a supportive-educational program, based on COPE model, on quality of life and caregiver burden of family caregivers of heart failure patients: a randomized clinical trial study.

BACKGROUND: Heart failure (HF) is one of the most common and spreading diseases worldwide. As HF symptoms progress, it is affected the quality of life and the caregiver burden of the family. The present study aimed to determine the effectiveness of the supportive-educational program, based on the COPE (creativity, optimism, planning and expert advice) care model, on the quality of life and caregiver burden of family caregivers of HF patients. METHOD: This clinical trial was conducted on 90 caregivers of HF patients admitted to Isfahan in 2021. The samples were divided into experimental (n = 45 people) and control (n = 45 people) groups based on random allocation (card method). The experimental group received problem-solving skills based on the four components of the COPE model in six sessions during one month. to collect data, the 36-Item Short Form Survey (SF-36) and the Zarit Burden Interview (ZBI) were used in two groups before, after and three months after the intervention. RESULTS: There was a significant difference between the experimental and control groups regarding gender, but This confounding factor had no significant effect on the two components of quality of life and caregiver burden. There was a significant difference between the two groups in terms of the mean score of quality of life immediately(75.99),and three months after the intervention (78.78) (P < 0.05) and the mean score of care burden, immediately (16.60) and three months after the intervention (12.73) (P < 0.05). CONCLUSIONS: One of the important duties of nurses is to implement educational-supportive programs for patients after the discharge of patients, These programs are family-oriented remotely for their caregivers. TRIAL REGISTRATION: This study was registered by the Iranian Registry of Clinical Trials with decree code: IRCT20211128053202N1on 2022-02-20.

Exploring internship nursing students' experiences regarding the effect of supervision model implementation on medication safety: A descriptive qualitative study.

BACKGROUND: Medication safety is one of the main aspects of safe care in the nursing profession, which leads to increasing patient safety and preventing medication errors. Clinical supervision is an integral part of nursing education that leads to the professional and social development of nursing students. This study was designed with the aim of revealing the experiences of nursing internship students from the implementation of the clinical supervision model on medication safety. MATERIALS AND METHODS: This descriptive qualitative study was done in 2022. The participants were selected from nursing internship students (Last year undergraduate) of Isfahan University of Medical Sciences, Isfahan, Iran. Participants in this study were 15 nursing internship students selected using a purposeful sampling method. Data were collected using in-depth semi-structured interviews. The qualitative content analysis approach was used for data analysis. RESULTS: After analyzing the data, four categories, "promotion medication safety competence and knowledge," "development trust and respect climate," "outcome of feedback," and "role of clinical supervisor," and 10 subcategories were extracted from the participants' experiences. CONCLUSION: The implementation of the clinical supervision model led to an increase in the competence of nursing internship students in medication safety. The students believed that this educational method made them follow the principles of medication safety administration. The feedback provided in the clinical supervision sessions made students think about their clinical activities, understand the reason for their mistakes, and use the reliable nursing resources introduced by the supervisor to improve their performance.

Medication safety climate from the perspectives of healthcare providers: A cross-sectional study.

BACKGROUND: Medication safety as an indicator of care quality is the measures taken by healthcare team members to prevent or adjust adverse drug events at the time of medication administration. This study was conducted to investigate the medication safety climate from healthcare providers' perspectives. MATERIALS AND METHODS: This cross-sectional descriptive study was conducted in a selected educational hospital affiliated with the Isfahan University of Medical Sciences, Isfahan, Iran, in 2021. Participants were healthcare providers who are involved in the medication process. The sampling was done using the quota method. The study instruments were a demographic questionnaire and the Medication Safety Climate (MSC). RESULTS: The total mean of positive responses to MSC items was 64.11%, denoting a moderate-level MSC. Collected data were managed using the SPSS software (v. 16.0) and were summarized using the measures of descriptive statistics, namely mean, standard deviation, frequency, and percentage. The lowest and the highest dimensional mean scores were related to the management support for medication safety dimension (mean: 48.42%) and the Teamwork dimension (mean: 80.43%), respectively. CONCLUSION: Managers' inattention and insufficient understanding of safety provide the basis for medication errors and threaten patient safety. Healthcare team members are highly motivated to provide quality and safe care by observing the managers' positive performance regarding patient safety. To improve the medication safety climate, healthcare team members are required to work in a safe workplace and have sufficient job satisfaction. Health center managers need to employ a proactive approach to prevent errors.

Cancer nurses' perspective of error disclosure from nurses to patients: A qualitative descriptive study.

PURPOSE: This study aims at exploring Cancer Nurses' Perspective of Error Disclosure. METHODS: This qualitative descriptive study was conducted in 2022, Iran. Data collection methods included observation (121 h), and semi-structured interviews (12 interviews with nurses, and nursing managers). Data analysis was performed using Graneheim and Lundman's approach. This study obtained ethical approval from Ethics Committee of Isfahan University of Medical Sciences. The COREQ checklist was used for study report. RESULTS: Data analysis resulted in three categories and nine subcategories: Error disclosure as a professional necessity (error disclosure as one of the patient's rights and error disclosure for self-and peer-learning), Error disclosure barriers (cancer-related factors, individual deterrents, nurses' intragroup culture, and organizational deterrents) and Error disclosure facilitators (culture of transparency, managerial support for error disclosure and development of error disclosure protocol). CONCLUSION: Creating a culture of error disclosure requires removing barriers, and providing facilitators. By reevaluating their professional performance and responsibilities, nurses may help foster a culture of error disclosure, and managers can do the same by encouraging employees and creating a clinical error disclosure manual. The promotion of an error disclosure to the patient culture may be greatly aided by managers. They facilitate this role by providing practical guidance (based on Iranian culture, needs and conditions of cancer patients and their families) to address nurses' concerns about managers' and the organization's negative responses.

Nursing students and faculty perception of academic incivility: A descriptive qualitative study.

BACKGROUND: Incivility is one of the significant challenges that affect nursing education. Uncivil behaviors have a significant upward trend compared to the past in nursing education. This study was conducted to explore academic incivility from the perspective of nursing students and faculty. MATERIALS AND METHODS: This study was conducted in 2021 using a descriptive qualitative method. Fifteen baccalaureate nursing students and six faculty were selected using purposeful sampling method. Data was collected through in-depth semi-structured interviews, and a qualitative content analysis was applied for data analysis. RESULTS: Data analysis revealed four categories, namely, ineffective teaching-learning, inapposite/unreasonable requests, behaviors disrupting mutually respectful environment, and academic dishonesty, and 14 subcategories. CONCLUSION: To reduce incivility, closer attention needs to be paid to the admission of faculty as well as training them to use effective communication techniques and interactive teaching methods. In addition, nursing students must be provided with the training about uncivil behaviors. Furthermore, clear and precise rules and regulations concerning incivility incidence should be developed and implemented in the universities.

Components of Compassionate Care in Nurses Working in the Cardiac Wards: A Descriptive Qualitative Study.

Introduction: Compassion is the essence and the core of nursing care. Nurse's affectionate and emotional work leads to many caring behaviours that are considered to be the basis of caring with kindness. The purpose of this study was to describe the components of compassion care in nurses working in the cardiac ward. Methods: This descriptive qualitative study was conducted in the medical and surgical cardiac wards of the selected hospital affiliation to Isfahan University of Medical Sciences in 2020- 2021. The participants were 36 nurses, 20 patients and 8 family members that selected using purposive sampling. Data collection was conducted through, in-depth semi-structured interviews; focus group discussions, and the field notes. Data analysis was carried out using the qualitative content analysis approach proposed by Graneheim and Lundman. Results: The results of this study are presented in one main category, four sub categories including "using verbal and non-verbal language to express feelings", "doing empathy activities", "organizing patient-centered care", and "adhering to the cultural context", and twelve sub- sub categories. Conclusion: The patient-centered emotional discourse is the main issue in shaping the compassion care in nurses. Nursing managers can have a significant role in achieving care with affection by preparing appropriate work environment, paying attention to lack of nursing staff, ensuring the principles defined in compassion care, and supporting nursing staff. Teaching the concept of compassion, patient-centered care in the clinical setting are among the most important issues that should be considered.

Exploring nursing faculty, managers, newly graduated nurses, and students' experiences of nursing internship program implementation in Iran: a descriptive qualitative study.

BACKGROUND: Nursing students are required to acquire the necessary clinical knowledge and skills to provide safe and quality care. The method of providing training, particularly for final-year nursing students, is of utmost importance. An internship is a program during which students work in shifts similar to nurses employed in a hospital; however, the number of their shifts and patients is less than nurses; a nurse and the faculty supervise the care they provide, and they are paid a monthly salary. This study was conducted to explore nursing faculty, managers, new graduates, and students' experiences of nursing internship program implementation. METHODS: This descriptive qualitative study was conducted from November 2021 to March 2022. The participants were selected from among nursing managers, newly graduated nurses, nursing internship students (final-year undergraduate), and faculty of Iran. Data were collected using in-depth semi-structured interviews. The qualitative content analysis approach was used for data analysis. RESULTS: Participants in this study included 17 nursing internship students, 12 nursing managers, three faculty members, ten nursing preceptors, and five newly graduated nurses from the internship program, 47 participants in total. After analyzing the data, five themes, including 'facilitation of socialization process,' 'filling the gap between theory and practice,' 'improving self-confidence and independence,' 'an opportunity for clinical skill training,' and 'Achilles' heel of the clinical setting,' and nineteen subthemes were extracted from the participants' experiences. CONCLUSION: Implementation of an internship program for final-year nursing students plays a role in preparing them for better professional performance, enhancing clinical skills, increasing self-confidence and independence, inspiring the nursing profession, strengthening professional commitment, and improving the chances of employment after graduation. In order to alleviate the identified challenges of the internship program, holding a briefing meeting with managers, supervisors, and faculty to determine working hours, performance standards, and amenities such as lunch, dinner, and resting place is efficient.

Assessment of medication administration of nurses in medical cardiac wards and its relationship with some demographic characteristics: An observational study.

BACKGROUND: Unsafe medication administration and medication errors pose a threat to medication safety. Safe medication is one of the most important nursing practices that plays an important role in preventing medication errors. The aim of this study was to assess the medication administration of nurses in cardiac wards and its relationship with some demographic characteristics. MATERIALS AND METHODS: The present study was conducted as an observational study in 2021 with the 60 nurses who working in the medical cardiac wards of one selected hospital affiliated with the Isfahan University of Medical Sciences. Data were collected using three-part tools (demographic information, medication checklist (55 items), and documentation checklist (8 items). The checklist was completed by the observer after observing the nurses' medication administration. Data analysis was conducted using descriptive and inferential statistics in the SPSS software (version 16, SPSS Inc., Chicago, IL, USA). A P < 0.05 was considered statistically significant. RESULTS: The mean total score of the principles of injection and oral medication administration were 82.53 ± 10.75 and 75.76 ± 9.62, respectively. The mean score of the principles of injection and oral medication administration in the morning shift was significantly higher than the evening and night shifts (P < 0.001). The relationship between the mean score of the principles of injection medication (r = 0.234, P = 0.067), oral medication (r = 0.222, P = 0.083), and the nurses' work experience no significant. The rate of adherence to the principles of medication administration in the premedication administration stage was higher than during and after drug administration. CONCLUSION: Although the mean score of medication administration of nurses in the medical cardiac wards was at the desired level, it is necessary to monitor and plan by nursing managers to improve medication administration. Reducing the number of night shifts, adhering to accreditation programs in the hospital, continuous monitoring of nurses in terms of compliance with the principles of medication are among the proposed solutions to improve the safe medication in nurses.

Exploring the experiences of nurses and physicians infected with COVID-19.

BACKGROUND: Health-care providers, including physicians and nurses, are vital resources of the health-care system, and their health is essential to ensure safe care and to control outbreaks in the community. The aim of this study was to explore the experiences of physicians and nurses infected with COVID-19. MATERIALS AND METHODS: This descriptive exploratory qualitative study was conducted in 2020. To conduct this study, 19 participants (5 physicians and 14 nurses) were selected using purposive sampling. Data were collected using semi-structured interviews. Data analysis was performed using conventional content analysis. RESULTS: Eight main categories of "Fear and anxiety," "Fighting against COVID-19," "Feeling abandoned during home quarantine period," "Denial of disease despite testing positive," "Recovery: the second opportunity," "Imposition of psychological burden after returning to work," "Promotion of the health professional perception," and "Promising supportive resources," as well as 21 subcategories, were extracted from the participants' experiences. CONCLUSION: The experiences of physicians and nurses with COVID-19 revealed that their perception of the profession and providing care had changed. This experience has highlighted the focus and effort to promote patient-centered care and interprofessional collaboration among them.

Development of a Patient Decision Aid to Help People Living with Inflammatory Bowel Disease.

BACKGROUND: Patient decision aid (PDA) is a tool, which helps the improvement of shared decisionmaking and is a part of the paradigm shift from physician-centered decisions to patient-centered shared decision making. In this study, we aimed to describe the process used to develop a PDA for facilitating shared decision-making about treatment in patients with inflammatory bowel disease (IBD) who need medication (corticosteroid, azathioprine, anti-TNF, and infliximab) or surgery. METHODS: The development process of PDA included: 1) The development of a prototype based on literature review and interview 2) 'Alpha' testing with patients and clinicians 3) 'Beta' testing in real conditions and 4) The production of a final version. This process took about 12 months (2019-2020). The participants were adult patients with IBD, gastroenterologists, and nurses. RESULTS: The final PDA contains four important sections: 1) Introduction about IBD disease, the purpose of developing PDA, and emphasis on shared decision-making 2) Benefits and risks of main medicines 3) The success rate as well as the incidence of complications after surgery, and 4) The conclusion about patients' satisfaction with PDA to choose the treatment options. Besides, PDA evaluation in the real world setting showed that 100% of physicians (n=4) and 86% of patients (n=12) were completely satisfied with the content of the PDA and considered it applicable and useful. CONCLUSION: This PDA can help patients participate in the shared decision-making process and select the best medical and surgical treatment methods. The feedback received from clinicians and patients showed their satisfaction with using the PDA.

Patient Safety Culture in Burn Care Units from the Perspectives of Healthcare Providers: A Cross-sectional Study.

Creating a positive patient safety culture is a key step in the improvement of patient safety in healthcare settings. Patient safety culture (PSC) is a set of shared attitudes, beliefs, and perceptions about patient safety (PS) among healthcare providers. This study aimed to assess PSC in burn care units from the perspectives of healthcare providers. This cross-sectional descriptive study was conducted in 2020 in the units of a specialty burn center. Participants were 213 healthcare providers recruited to the study through a census. A demographic questionnaire and the Hospital Survey on Patient Safety Culture were used for data collection. Data were managed using the SPSS16 software and were summarized using the measures of descriptive statistics. The mean of positive responses to PSC items was 51.22%, denoting a moderate-level PSC. The lowest and the highest dimensional mean scores were related to the no punitive response to error dimension (mean: 12.36%) and the teamwork within departments dimension (mean: 73.25%), respectively. Almost half of the participants (49.3%) reported acceptable PS level in their workplace and 69.5% of them had not reported any error during the past 12 months before the study. Given the great vulnerability of patients with burn injuries in clinical settings, improving PSC, particularly in the no punitive response to error dimension, is essential to encourage healthcare providers for reporting their errors and thereby, to enhance PS. For quality care delivery, healthcare providers in burn care units need a safe workplace, adequate managerial support, a blame-free PSC, and an incentive error reporting system to readily report their errors.

Challenges to Family Caregivers in Caring for Gastric Cancer Patients from Perspectives of Family Caregivers, Patients, and Healthcare Providers: A Qualitative Study.

OBJECTIVES: Cancer affects both patients and their families. Sometimes, the effects of cancer on families are greater than its effects on patients. Family caregivers play significant roles in care for patients with cancer. Nonetheless, the data on the challenges they face in caregiving are limited. The present study explored the perspectives of patients with gastric cancer (GC), their family caregivers, and healthcare providers regarding family caregivers' challenges in caregiving to patients with GC. MATERIALS AND METHODS: This descriptive exploratory qualitative study was conducted in 2019-2020. Six GC patients, six family caregivers, three physicians, and five nurses took part for a total of twenty participants. Purposive sampling was performed, and data were collected through semi-structured interviews and continued up to data saturation. Conventional content analysis was used for data analysis. RESULTS: Caregivers' challenges in caregiving to patients with GC were grouped into five main categories, namely, lengthy process of GC diagnosis, delivery of bad news, management of physical symptoms, altered relationships, and psychological consequences, and 14 subcategories. CONCLUSION: Educating the public about the primary symptoms of GC and the importance of timely seeking medical care as well as using culturally appropriate protocols for delivering bad news is recommended. Empowering family caregivers for the effective management of GC symptoms and caregiving-related challenges are also recommended to reduce their caregiver burden.

The effect of pregnancy training classes based on bandura self-efficacy theory on postpartum depression and anxiety and type of delivery.

BACKGROUND: Postpartum depression and anxiety is one of the most common complications that women face and cause many problems for mother, baby, and family. Considering the effect of self-efficacy on women's adaptation to pregnancy and delivery conditions and their mental health during this period, the present study was designed to investigate the effect of pregnancy training classes based on Bandura self-efficacy theory on postpartum depression and anxiety and type of delivery. MATERIALS AND METHODS: In this clinical trial study, 64 pregnant women were randomly divided into intervention and control groups. Mothers in the intervention group received pregnancy training in eight sessions (each session was 2-hour) from the 20th week of pregnancy. The classes were run by a trained midwife and the content of the training was based on Bandura self-efficacy components. The mothers in the control group received routine care. The demographic-reproductive information form, Beck Depression and Spielberger Anxiety Questionnaire were completed by pregnant women of both groups at several times, before the program, 1 week and 1 month after delivery. RESULTS: The results showed that the training program significantly decreased the depression score in 1 week and 1 month after delivery in the intervention group compared to the control group. In addition, this training program decreased the mean score of apparent and hidden anxiety in the intervention group 1 month after delivery, although this decrease was not statistically significant. Furthermore, 80.55% of the intervention group and 58.33% of the control group had vaginal delivery, which were significantly different between the two groups in terms of the type of delivery. CONCLUSION: The findings showed that pregnancy training classes based on Bandura self-efficacy theory decrease depression and anxiety and increases vaginal delivery rate.

Nutritional challenges of gastric cancer patients from the perspectives of patients, family caregivers, and health professionals: a qualitative study.

PURPOSE: This study aims to explore the perceptions of gastric cancer patients, their family caregivers, physicians, and nurses of nutritional challenges. METHODS: Using a descriptive qualitative method, this study was conducted in 2019-2020. Twenty participants (6 patients, 6 family caregivers, 3 physicians, and 5 nurses) were selected through purposive sampling. Data was collected through in-depth semi-structured interviews and examined using qualitative content analysis. RESULTS: Data analysis revealed three categories, each with two subcategories: eating, an unpleasant experience that contains "a feeling like hyperemesis gravidarum" and "childish food excuses"; flexibility while adhering to a proper diet, which consists of "dietary dos and don'ts" and "nutritional leniency"; and nutrition with distress that contains "patient's sense of being an extra burden" and "provision of nutrition with suffering in caregivers." CONCLUSION: Because of the significant physical and psychological impact of nutritional problems on patients and their caregivers, the need to provide care and education to these patients and their families using a multidisciplinary team is becoming more important.

Effect of interprofessional education of medication safety program on the medication error of physicians and nurses in the intensive care units.

BACKGROUND: The safety of hospitalized patients in the intensive care units (ICUs) is threatened due to incidents and adverse events, including medication errors. Medication error refers to any preventable event at different stage of medication process, such as prescription, transcription, distributing medication, and administration, which can lead to incorrect use of medicines or damage to the patient. This study aimed at investigating the effect of the interprofessional education of medication safety program on medication errors of physicians and nurses in the ICUs. MATERIALS AND METHODS: The study was conducted using a quasi-experimental method (single group, before and after) in 2017. The setting of the study included one ICU of selected teaching hospital affiliated to Isfahan University of Medical Sciences located in the Central Iran with a total of 23 beds. Participants included 50 members of the health-care team (physician, nurse, and clinical pharmacist) with at least 1 year of work experience in the ICUs. Participants were selected using censuses sampling method. Data were collected using a two-section self-made questionnaire. Data were analyzed through descriptive, analytical statistics, and version 16 of the SPSS software (P < 0.05). RESULTS: According to reporting of physicians, nurses, and clinical pharmacist, the medication error 1 month after implementation, the interprofessional education of medication safety program was significantly lower than before the implementation of it (P < 0.001). CONCLUSIONS: Interprofessional education helps to improve interprofessional collaboration and patient care through the promotion of various professions of health to increase interprofessional collaboration compared to single profession education, which individuals learn in isolation and merely in their profession. Therefore, interprofessional education of medication safety program can reduce medication error and promote patient safety in the ICUs.

Caring Burden and Quality of Life of Family Caregivers in Patients Undergoing Hemodialysis: A Descriptive-Analytic Study.

BACKGROUND: Caring role, especially in chronic diseases, has a negative impact on the health of family caregivers and can affect their quality of life. Therefore, this study aimed to investigate the care burden and quality of life in family caregivers of hemodialysis patients and their relationship with some characteristics of caregivers and patients. METHODS: This study was conducted as a descriptive-analytic study in Isfahan from January to February 2017. Sampling was done using census. The number of participants was 254. The data gathering tools consisted of a three-part questionnaire including demographic characteristics, the Zarit questionnaire for caring burden, and SF-36 quality of life questionnaire. Data were analyzed using descriptive statistics, Pearson correlation coefficient test, Spearman's coefficient, ANOVA, and univariate general linear regression. A significant level of 5% was considered. RESULTS: The mean scores of the quality of life and caring burden were 30.54±9.89 and 44.98±6.82, respectively in caregivers. The age of the patient under care (P<0.001), cost of medications (P=0.008), and hours of care in 24 hours (P<0.001) had a significant relationship with care givers' quality of life. Also, univariate general linear regression revealed that care burden had a significant relationship with the quality of life (P=0.003). CONCLUSION: Family caregivers who experienced more caring burden had a low quality of life. The researchers suggest that supportive and educational programs should be designed and implemented for this group of patients and their caregivers.

Exploring the challenges of clinical education in nursing and strategies to improve it: A qualitative study.

BACKGROUND: Clinical education is the heart of professional education in nursing. The perspective of nursing students and clinical nursing educators as the main owners of teaching-learning process are of determinants affecting clinical education process. This study was conducted to explore and to describe the clinical education problems and strategies to improve it from the perspective of nursing students and clinical nursing educators. MATERIALS AND METHODS: The study was conducted using a descriptive qualitative method in 2017. Participants included 35 baccalaureate nursing students and 5 clinical nursing educators from nursing faculty of Isfahan University of Medical Sciences, Isfahan, Iran. Participants were selected using purposeful sampling method. Data were collected through semi-structured individual interviews and used qualitative content analysis for analysis. RESULTS: The 2 main categories, 7 subcategories, and 19 sub-sub categories extracted from interviews. The two categories were "challenges of clinical education in nursing with four subcategories: fear, insufficient readiness of student, incompetency of clinical educators, unpleasant atmosphere of clinical environment," and "strategies for improving clinical education of nursing with three subcategories: the use of nursing education models and methods, improvement of communication between faculty and practice, and holding orientation stage at the beginning of training." CONCLUSIONS: The findings show that clinical strategies, including employing experienced clinical educators, attempting to enhance the learning environment, developing the relationship between faculty and practice, participation of clinical nurses in clinical education, paying attention to entering behavior, and holding orientation stage at the beginning of training, can improve clinical education of nursing.

The most frequent and important events that threaten patient safety in intensive care units from the perspective of health-care professionals'.

BACKGROUND: Patient safety is a priority in all health-care centers across the world. This study aimed to determine the frequency of events that threaten patient safety and the grade threating of events from the perspective of the health-care professionals in the intensive care units (ICUs). MATERIALS AND METHODS: This cross-sectional study was conducted in 2016. The participants were 306 members of health-care professionals (physicians and nurses) with at least 1 year of work experience in ICUs of educational hospitals affiliated to Isfahan University of Medical Sciences. Data were collected using a three-section self-made questionnaire. Data analysis was done using descriptive statistics (frequency distribution and percentage) and version 16 of SPSS software. RESULTS: A total of 306 questionnaires were completed out of 320 questionnaires handed out among participants. During the last month, 91.2% of the participants had reported at least a case of medication error, 75.6% had reported at least a case of ventilator-associated pneumonia, and 74.2% had reported at least a case of catheter-induced urinary infection in ICUs. CONCLUSION: The occurrence of events threatening the patient safety in ICUs warrants proper planning by administrators of health-care centers. Medication error was the most frequent and important event of threat to patient safety and falling was the least frequent event of threat to patient safety in ICUs. Considering the frequency and magnitude of medication error in ICUs, a well-adjusted preventive plan should be designed and implemented to improve the patient safety.