Background & Aims One of the factors that seems to influence the incidence of moral distress (MD) in nurses is resilience. This study aimed to investigate the relationship between resilience and MD in nurses working in emergency departments (EDs). Materials & Methods This is a descriptive-analytical study with a cross-sectional design that was conducted from April to June 2024 on 133 nurses from the EDs of hospitals in Urmia city, Iran, who were selected using a two-stage sampling method. They completed a sociodemographic form, the Connor Davidson Resilience scale, and Nash's moral injury events scale (MIES). Data analysis was performed using Pearson’s correlation test, multiple linear regression analysis, independent t-test, and one-way analysis of variance in SPSS software, version 23. Results The mean age of the participants was 32.7±45.5 years. The mean resilience score was 78.33±0.54, and the mean MIES score was 30.19±8.44. There was a significant negative relationship between resilience and MD among ED nurses (r=-0.45, P=0.001). Conclusion Given the relationship between resilience and MD in ED nurses, the increase in their resilience can reduce their MD level. Therefore, nursing managers should take measures such as organizational support and improving working conditions to promote the resilience of ED nurses and, thus, reduce their MD.

Background & Aims Nurses often face ethical challenges in their work place, which can significantly impact their quality of work life (QWL). This study aims to examine the relationship between moral distress and QWL in Iranian nurses. Materials & Methods This descriptive-correlational study was conducted from April to July 2023 in teaching hospitals of Kerman province (Kerman, Bam, Jiroft cities), southeast of Iran. A total of 290 nurses with at least a bachelor’s degree and six months of full-time work experience were selected using a stratified random sampling method. The data collection tools included a demographic form, Corley et al.’s revised moral distress scale (MDS) and the quality of nursing work life scale. Data were analyzed using SPSS software, Version 20, with a significance level set at 0.05. Results The mean score of moral distress was 140.61±43.795, and the mean score of QWL was 155.9±25.077. A moderate negative relationship was observed between moral distress and QWL (R=-0.562, P<0.05), and a weak negative relationship was found between the intensity (R=-0.042, P<0.05) and frequency of moral distress (R=-0.063, P<0.05) and QWL Conclusion The increase in moral distress is associated with a decrease in the QWL among Iranian nurses. Hospital managers should develop policies and interventions for improving the work environment and thus reducing moral distress of nurses.

Background & Aims Telenursing is a strategy for supporting and empowering mothers of premature infants. This study aimed to determine the impact of telenursing on breastfeeding self-efficacy, infant weight, and frequency of readmission to neonatal intensive care units (NICUs) in these mothers. Materials & Methods In this quasi-experimental study, 60 mothers of preterm infants discharged from the NICUs of three hospitals affiliated to Isfahan University of Medical Sciences, Iran in 2022 were selected using a convenience sampling method. They were divided into two groups of 30, including intervention and control. The intervention group received a telenursing program that included breastfeeding consultation, nutritional consultation, and emotional support for eight weeks after discharge, while the control group received the routine post-discharge follow-up program. After the study, infant weight gain, NICU readmission, and breastfeeding self-efficacy (using Dennis’s breastfeeding self-efficacy scale) were assessed. For statistical analysis, descriptive statistics, chi-square test, and independent t-test were used. Results The mean breastfeeding self-efficacy score differed significantly between the two groups after intervention, with a mean score of 154.4±4.3 in the intervention group and 124.8±5.30 in the control group. In terms of infant weight, significant differences were reported between pre-test and post-test weights in each group (P<0.05), but no significant difference in weight gain was observed between the two groups (P=0.45). The NICU readmission rate in the control group was 3.33%, while no readmission was reported in the intervention group. Conclusion Telenursing interventions focused on education, consultation, and addressing infant care challenges via online messaging platforms can significantly enhance breastfeeding self-efficacy of mothers and reduce the need for readmission of their infants to NICUs.

Background & Aims Spiritual well-being (SWB) is a key factor for improving students’ quality of life and well-being. This study aims to investigate the SWB status in Iranian college students and assess its relationship with academic achievement. Materials & Methods This is a systematic review study. To find the information, a search was conducted in the databases of Web of Science, Scopus, PubMed, Google Scholar, Scientific Information Database (SID) and MagIran for Persian and English articles published between 2000 and 2024 using the keywords academic performance, student, Iran, academic achievement, spiritual health and SWB. Initially, the search yielded 168 articles. After removing duplicates and screening the titles, abstracts, and full texts of the studies, 13 articles were finally included in the review. Results Most of the studies reported an moderate level of SWB in Iranian students, and a significant positive correlation between their SWB and academic achievement. The students with higher levels of SWB tended to have better academic performance. Conclusion Attention to the SWB of Iranian students can be an effective strategy for enhancing their academic achievement. It is recommended that educational and counseling programs provided in the Iranian universities have a more focus on improving the students’ SWB.

Background & Aims COVID-19 can cause serious kidney issues. To diagnose kidney function and diseases of the urinary tract, a complete urine test is needed. This study aims to determine the relationship between complete urine test findings and disease outcomes in patients with COVID-19 admitted to a hospital in Shahroud, Iran. Materials & Methods This is a descriptive-analytical study with a cross-sectional design. In this study, 1134 data related to the patients with COVID-19 admitted to Imam Hossein Hospital affiliated to Shahroud University of Medical Sciences from March 20, 2020 to June 20, 2021 were examined. The diagnosis of COVID-19 was based on a positive nasal or nasopharyngeal swabs by RT-PCR test, or the result of a lung CT scan showing ground-glass opacities. Three checklists were used to record demographic data, urine test findings, and disease outcomes. Logistic regression analysis and independent and dependent t-tests were used for data analysis. Results Urine appearance, bacteria in urine, blood in urine, castes in urine, crystals in urine, protein in urine, red blood cells in urine, white blood cells in urine, yeast cells in urine, colony count in urine, and positive urine culture had a significant relationship with death and their hospitalization in ICU (P<0.05). Also, ketone in urine, mucus in urine, and specific gravity of urine had a significant relationship with the intubation in ICU (P<0.05). Conclusion The changes in urine test parameters in patients with COVID-19 is associated with the disease outcomes. Therefore, accurate monitoring of urinary parameters in these patients is recommended for rapid diagnosis of any complications related to the disease.

Background & Aims Participating in specialized nursing empowerment training programs can improve nurses’ skills. Empowering nurses is very important for providing quality care. This study aimed to investigate the impact of an empowerment training program on the job satisfaction of nurses in Iran. Materials & Methods This is a quasi-experimental study with a pre-test/post-test design. The study population consists of all nurses working in the hospitals of eight deprived cities in Iran (Ahvaz, Hormozgan, Zahedan, Ilam, Abadan, Zabol, Torbat-e Jam and Iranshahr) in 2018-2019. We selected 240 nurses with a work experience <20 years from the special wards of hospitals (ICU, CCU, dialysis, emergency) using a purposive sampling method. They were divided into two groups of intervention (n=120) and control (n=120) who were matched based on educational level, gender, work experience and age. A specialized training program was provided to the intervention group based on Kirkpatrick’s training evaluation model for three months (one 90-minute session per week), but the control group did not receive any training. ANCOVA was performed for statistical analysis in SPSS software, version 16. Results Job satisfaction after intervention was significantly different between the two groups (F=152.37, P=0.001). Empowerment training could significantly increase nurses’ job satisfaction. Conclusion Empowerment training can increase the job satisfaction of Iranian nurses. Therefore, continuous in-service empowerment training programs for nurses are recommended to promote their job satisfaction. The results of this study can help healthcare officials and policymakers in Iran identify factors affecting nurses’ skills and performance.

Background & Aims Psychiatric nurses are responsible for establishing or maintaining a safe and therapeutic environment for patients and ensuring optimal clinical supervision of restraints based on the standards in the psychiatric ward. This study aimed to determine the knowledge, attitude, and practice of nurses working in the Razi Psychiatric Hospital, Tabriz, Iran, regarding the use of physical restraints. Materials & Methods This is a descriptive cross-sectional study conducted in 2022. The study population consists of all nurses working in the psychiatric wards of Razi Hospital in Tabriz, Iran. We selected 200 eligible nurses using a convenience sampling method. The data collection tools were a demographic form and a knowledge, attitude and practice scale regarding the use of physical restraints. The data were statistically analyzed in SPSS software version 18. Results The mean scores of knowledge, attitude and practice were 19.36±1.73 (out of 23), 36.51±4.60 (out of 60) and 65.19±3.29 (out of 75), respectively. The practice score had a statistically significant correlation with work experience in psychiatric wards (P=0.048) and knowledge score (P=0.016). Conclusion It is better to provide in-service training programs for psychiatric nurses to improve their knowledge, attitude and practice regarding the use of physical restraints. Nursing managers can plan to reform the structure of psychiatric wards and increase the motivation of psychiatric nurses to improve their attitudes and practice regarding the use of physical restraints.

Background & Aims Central line-associated bloodstream infections (CLABSI) are a common type of nosocomial infections, with a higher prevalence among healthcare providers, including nurses who play an important role in preventing these infections due to their responsibility for routine care of central venous catheters (CVCs). Regular evaluation of nurses' knowledge and compliance with evidence-based guidelines for CLABSI prevention are thus important. This study aims to determine the knowledge and practice of nurses in preventing CLABSI in intensive care units (ICUs) of hospitals for Iran University of Medical Sciences (IUMS), Tehran, Iran. Materials & Methods In this descriptive study, 200 nurses working in the ICUs of hospitals affiliated to the IUMS in 2023 were included using a convenience sampling method. To collect data, a demographic form, a self-report knowledge scale, and a practice checklist based on the clinical care guidelines of the New South Wales Institute for Clinical Innovation & Emergency Care for preventing CVC-related infections were used. The collected data were analyzed in SPSS software, version 16. Results The nurses' mean knowledge score was 6.44 ± 1.44. There was a significant difference in the knowledge score based on age (P=0.006), work experience (P=0.001), and ICU work experience (P=0.006). The practice of nurses varies in different dimensions, and the most unfavorable practices were in the fields of "using 2% chlorhexidine gluconate in 70% isopropyl alcohol for cleaning the injection site during dressing changes", "using sterile gloves to put on a new dressing", and "disinfecting the injection port without needles and vascular access tools with a disposable applicator dipped in 70% isopropyl alcohol”. Conclusion The knowledge of ICU nurses from the IUMS hospitals regarding the prevention of CVC-related infections is at a moderate to high level. Older nurses and those with more work experience and ICU work experience have higher knowledge. Although the practice of these nurses are favorable in most cases, their poor practice in some areas should be considered as it can affect infection control, quality of care, and patient safety. Hospital managers should provide educational interventions for nurses regarding proper CVC care and the guidelines should be made available to all departments, especially ICUs.

Background & Aims Providing high-quality services in service organizations, especially healthcare organizations, is crucial. Quality services can lead to patient satisfaction and reduce costs. This study aims to survey nurses' perceptions of the quality of nursing care provided in hospitals affiliated to Iran University of Medical Sciences (IUMS), Tehran, Iran. Keywords: Quality assessment, Nursing Care, Quality Materials & Methods This descriptive cross-sectional study was conducted on 265 nurses working in hospitals affiliated to IUMS in 2021, who were selected using stratified sampling with proportional allocation. The data collection tools included a sociodemographic form and the Scale of Perception of Nursing Activities that Contribute to Nursing Care Quality (EPAECQC). Results The mean age of participants was 34.32±7.39 years, and most of them were female (67.2%). The mean total EPAECQC score was 76.35±12.50, with the highest score in the dimension of responsibility/rigor (3.28±0.54) and the lowest score in the dimension of health promotion (2.79±0.70). Conclusion The overall quality of nursing services in hospitals affiliated to IUMS is at a desirable level. Attention should be paid to the dimensions of nursing care quality, especially patient satisfaction and health promotion, in nursing education.

Background & Aims Nurses play a significant role in maintaining and promoting patient health, and their knowledge and practice in managing complex interventions such as chest tube management for critically ill patients are crucial to prevent complications and accelerate patient recovery. This study aimed to assess the knowledge and performance of nurses working in hospitals in Ardabil, Iran, regarding the provision of care to patients with chest tube, and find the related factors. Materials & Methods This descriptive- correlational study was conducted on 265 nurses working in the ICU, emergency, and surgical wards of hospitals affiliated with Ardabil University of Medical Sciences (AUMS) in 2023. Data were collected using a reliable and valid three-part questionnaire to assess nurses' demographic characteristics, knowledge, and practice regarding chest tube care. The collected data were analyzed in SPSS software, version 23 using descriptive and inferential statistics. Results Overall, nurses' knowledge was at a moderate level (48.28±8.49). Only 12 nurses (4.52%) achieved satisfactory scores. Regarding nursing practice, most nurses (n=259, 97.73%) obtained satisfactory scores. There was a significant correlation between knowledge and practice variables (r=0.170, P=0.003). Nurses' educational level had a significant association with their knowledge (B=3.090, P=0.008) and practice (B=2.299, P=0.010). Conclusion Due to the low number of AUMS nurses with satisfactory knowledge scores regarding the care for patients with chest tube, it is necessary to hold continuous training courses for nurses on effective care for patients with chest tube care in the AUMS hospitals.