scholarly journals The Effect of Sedation Protocol Using Richmond AgitationSedation Scale (RASS) on Some Clinical Outcomes of Mechanically Ventilated Patients in Intensive Care Units: a Randomized Clinical Trial

2019 ◽  
Vol 8 (4) ◽  
pp. 199-206 ◽  
Author(s):  
Zahra Taran ◽  
Masoumeh Namadian ◽  
Soghrat Faghihzadeh ◽  
Taraneh Naghibi
Keyword(s):  
Clinical Trial ◽  
Intensive Care ◽  
Clinical Outcomes ◽  
Health Care Professionals ◽  
Intervention Group ◽  
Routine Care ◽  
Final Outcome ◽  
Control Group ◽  
Sedation Protocol ◽  
The Cost

Introduction: Providing for patients’ comfort and reducing their pain is one of the important tasks of health care professionals in the Intensive Care Unit (ICU). The current study was conducted to determine the effect of a protocol using a Richmond Agitation-Sedation Scale (RASS) on some clinical outcomes of patients under mechanical ventilation (MV) in 2017. Methods: This single-blind clinical trial was conducted on 79 traumatic patients in the ICU who were randomly allocated into the intervention (N=40) and the control groups (N=39). The sedation was achieved, using a sedation protocol in the intervention group and the routine care in the control group. The clinical outcomes of the patients (duration of MV, length of staying in ICU, final outcome) were measured. As the participants had different lengths of MV and staying in ICU, the data were restructured, and were analyzed, using proper statistical methods. Results: The patients’ level of sedation in the intervention group was significantly closer to the ideal score of RASS (-1 to +1). The duration of MV was significantly reduced in the intervention group, and the length of stay in the ICU was also significantly shorter. There was no difference in terms of final outcome. The ICU cost in the control group was twice as high as the cost in of the intervention group. Conclusion: The applied sedation protocol in this study would provide better sedation and could consequently lead to significantly better clinical outcomes, and the cost of caring as a result.

Impact of Stress Ulcer Prophylaxis Algorithm Study

2005 ◽  
Vol 39 (5) ◽  
pp. 810-816 ◽  
Author(s):  
Christian J Coursol ◽  
Sabrina E Sanzari
Keyword(s):  
Intensive Care ◽  
Stress Ulcer ◽  
Treatment Algorithm ◽  
Intervention Group ◽  
Stress Ulcer Prophylaxis ◽  
Control Group ◽  
Post Intervention ◽  
Ulcer Prophylaxis ◽  
The Cost ◽  
The Impact

BACKGROUND: In the intensive care unit at Royal Victoria Hospital, we noted that drugs prescribed for stress ulcer prophylaxis were not always indicated or optimal. Accordingly, we implemented an algorithm for stress ulcer prophylaxis to guide the medical team in their decisions. The agents selected for the algorithm were intravenous famotidine and omeprazole suspension or tablets, depending on the available administration route. OBJECTIVE: To evaluate the impact of a treatment algorithm on the appropriateness of prescriptions for stress ulcer prophylaxis. METHODS: A quasi-experimental—type evaluative study was conducted based on a pre-/post-intervention design without a concurrent control group. A total of 555 complete admissions met the selection criteria; 303 patients formed the pre-intervention group, and 252 made up the post-intervention group (exposed to the treatment algorithm). RESULTS: After implementation of the algorithm, the proportion of inappropriate prophylaxis was decreased (95.7% vs 88.2%; p = 0.033). The number of days of inappropriate prophylaxis was also reduced significantly (p = 0.013), as was the cost per patient (p = 0.003) for all admissions. However, no difference was observed when the subgroup of patients who received prophylaxis alone was studied (p = 0.098 and p = 0.918). The presence of bleeding was similar in both groups. CONCLUSIONS: Introduction by pharmacists of a treatment algorithm for stress ulcer prophylaxis in intensive care units allows a reduction of inappropriate prescriptions and thus a reduction in the cost of drugs. The use of omeprazole suspension seems to be an alternative to intravenous histamine2-inhibitors; however, a large-scale study is necessary to confirm the efficacy and safety of proton-pump inhibitors administered by an enteral tube.

scholarly journals The Effect of Emotional Disclosure by Writing on the Depression of Hemodialysis Patients in Iran: A Randomized Clinical Trial

2021 ◽  
Vol 10 (4) ◽  
pp. 223-229
Author(s):  
Fereshteh Khaleghi ◽  
Batool Pouraboli ◽  
Leila Abadian ◽  
Mahlegha Dehghan ◽  
Sakineh Miri
Keyword(s):  
Clinical Trial ◽  
Intervention Group ◽  
Psychological Problem ◽  
Routine Care ◽  
Depression Score ◽  
Emotional Disclosure ◽  
T Test ◽  
Control Group ◽  
Depression Anxiety Stress Scale ◽  
The Difference

Introduction: Depression is the most common psychological problem in patients with renal failure, and it can lead to mortality in severe cases. Effective interventions are required to promote mental health in patients on hemodialysis with various types of mental disorders. The current study aimed to evaluate the effect of emotional disclosure by writing on depression of patients on hemodialysis in Iran. Methods: This clinical trial study was carried out on 140 patients undergoing hemodialysis in hemodialysis centers of Kerman. Patients were randomly assigned into two groups of intervention and control after signing the written consent forms and completing the Depression Anxiety Stress Scale (DASS 21). The intervention group was requested to write daily the deepest emotions and intrusive thoughts within 15 to 20 minutes in four consecutive days. The control group received routine care. Then, the questionnaire was recompleted two weeks later. Finally, the data were analyzed by SPSS (version 13) using independent t-test and paired t-test. Results: The mean depression score was either moderate or high. While depression scores seemed to decrease in the intervention group after the intervention, the depression scores continued to rise following the intervention in the control group. The difference in depression scores was statistically significant between the two groups before and after the intervention. Conclusion: Emotional disclosure by writing can be effective on the level of depression in patients on hemodialysis.Simus adi omnimodipsa sam fugita dolenistiae inveles est doluptat.

Effect of Nebulized Eucalyptus for Preventing Ventilator-Associated Pneumonia in Patients under Mechanical Ventilation: A Randomized Double Blind Clinical Trial

2018 ◽  
Author(s):  
HasanAli Karimpour ◽  
Behzad Hematpour ◽  
Saeed Mohammadi ◽  
Javad Aminisaman ◽  
Maryam Mirzaei ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Intervention Group ◽  
Control Group ◽  
Pulmonary Infections ◽  
Double Blind ◽  
Double Blind Clinical Trial ◽  
And Control ◽  
And Staphylococcus Aureus

Abstract Background: Pneumonia caused by the ventilator is the most common acquired infection in the intensive care unit, which increases the morbidity and mortality of the patients. Eucalyptus plant has antiseptic properties. Therefore, the present study investigates the effect of eucalyptus incense on prevention of pneumonia in patients with endotracheal tube in the intensive care unit. Methods: This clinical trial study was performed on 100 patients under ventilation in two intervention and control groups in Imam Reza Hospital, Kermanshah, Iran in 2018. The patients in the intervention group, Eucalyptus solution 2% and in the control group received 10 cc distilled water as an inhaler three times a day. The results of the two groups were compared to the incidence of pulmonary infections based on CPIS criteria and compared with SPSS version 19 software. Results: The incidence of late pneumonia was significantly lower in the intervention group (P=0.02). The onset of pneumonia significantly later in the intervention group than the control group (P=0.01). The prevalence of Klebsiella, Candida albicans, and Staphylococcus aureus was significantly decreased in the intervention group (P=0.02) (P=0.04) (P=0.01). Conclusion: The results of this study showed that eucalyptus inhalation is effective in reducing the incidence of pulmonary infection in patients under ventilation. It is recommended that these products be used to prevent pulmonary infections in these patients.

scholarly journals Chlorhexidine and gauze and tape dressings for central venous catheters: a randomized clinical trial

2014 ◽  
Vol 22 (5) ◽  
pp. 764-771 ◽  
Author(s):  
Edivane Pedrolo ◽  
Mitzy Tannia Reichembach Danski ◽  
Stela Adami Vayego
Keyword(s):  
Clinical Trial ◽  
Intensive Care ◽  
Randomized Clinical Trial ◽  
Intervention Group ◽  
Bloodstream Infections ◽  
Central Venous Catheters ◽  
University Hospital ◽  
Control Group ◽  
P Value ◽  
Central Venous

OBJECTIVE: to assess the effectiveness of the chlorhexidine antimicrobial dressing in comparison to the gauze and tape dressing in the use of central venous catheters.METHOD: a randomized clinical trial was conducted in the intensive care and adult semi intensive care units of a university hospital in the south of Brazil. The subjects were patients using short-term central venous catheters, randomly assigned to the intervention (chlorhexidine antimicrobial dressing) or control (gauze and micro porous tape) groups.RESULTS: a total of 85 patients were included: 43 in the intervention group and 42 in the control group. No statistically significant differences were found between dressings in regard to the occurrence of: primary bloodstream infections (p-value = 0.5170); local reactions to the dressing (p-value = 0.3774); and dressing fixation (p-value = 0.2739).CONCLUSION: both technologies are effective in covering central venous catheters in regard to the investigated variables and can be used for this purpose. Registry ECR: RBR-7b5ycz.

scholarly journals The effect of group therapy using the cognitive approach on the empowerment of mothers raising a child with autistic disorder:A randomized-controlled clinical trial

2019 ◽  
Vol 7 (1) ◽  
pp. 23-31
Author(s):  
Hossein Ebrahimi ◽  
Maryam Vahidi ◽  
Ayyoub Malek ◽  
Jalil Babapour Kheiroddin ◽  
Nafiseh Abdorrahmani
Keyword(s):  
Clinical Trial ◽  
Group Therapy ◽  
Autistic Disorder ◽  
Intervention Group ◽  
Routine Care ◽  
T Test ◽  
Analysis Of Covariance ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Cognitive Approach

Introduction: The diagnosis of autistic disorder may impose stress on the child’s parents especially the mother of the baby. Raising a child with autistic disorder reduces parents' quality of life. This study examined the effect of group therapy using a cognitive approach on empowerment in the mothers of children with autistic disorder. Methods: This randomized clinical trial was carried out with 80 mothers of children with the autistic disorder. They referred to Autism Society Rehabilitation Center in Tabriz, Iran. The mothers were randomly allocated into intervention and control groups. The intervention group was divided into 4 groups of 10, and each group participated in 10 sessions of group therapy using the cognitive approach. The control group received the routine care. Data were collected using the Family Empowerment Scale (FES) before the intervention and two months after the intervention. Data were analysed using descriptive and inferential statistics [t-test, χ2, and analysis of covariance (ANCOVA)] via the SPSS software. Results: The independent t-test showed that the means of total empowerment and its dimensions had no statistically significant differences before the intervention. However, after the intervention, such differences between the groups were statistically significant (P < 0.001); so that the mothers in the intervention group achieved higher scores on empowerment and its dimensions compared with the control group. Conclusion: Group therapy using the cognitive approach can be used by healthcare professionals in rehabilitation centers for empowering the mothers of children with autistic disorder.

scholarly journals Effect of self-hypnosis on the experience of delivery fear and duration of labor in primiparity: A randomized clinical trial

2020 ◽  
Keyword(s):  
Clinical Trial ◽  
Intervention Group ◽  
Routine Care ◽  
Control Group ◽  
P Value ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Spss Software ◽  
Negative Side Effects ◽  
And Control

Background and Aims: Fear of delivery in females can lead to negative side effects, such as the experience of long and hard labor. Reduction of delivery fear is one of the goals of natural delivery program, and hypnosis has been considered a way to reduce this fear. With regard to the contradictory results of the studies in this field, this study aimed to determine the effect of self-hypnosis on the experience of delivery fear and duration of labor in primiparity. Materials and Methods: This clinical trial was conducted on 63 pregnant women who were divided into self-hypnosis (n=30) and control groups (n=33) using a blocking method in Mashhad, Iran, during 2019. The intervention group received two sessions of hypnosis at 37th and 38th weeks of pregnancy which consisted of listening to an audio file until delivery time. On the other hand, the control group received only the routine care. Fear was evaluated at 37th week of pregnancy and 24 h after delivery. Data were analyzed using SPSS software (version 16), and a p-value less than 0.05 was considered statistically significant. Results: The mean scores of delivery fear experience (P<0.001), as well as the duration of the second stage (P=0.013) and third stage of labor (P=0.009) were significantly lower in the self-hypnosis group, compared to the controls. Conclusion: Self-hypnosis was effective in reducing the experience of delivery fear and duration of the second and third stages of labor in primiparity. Therefore, self-hypnosis is recommended to reduce the experience of delivery fear and duration of the second and third stages of labor in primiparity.

scholarly journals The effect of rosemary ointment on the pressure ulcer healing in patients admitted to the intensive care unit: A randomized clinical trial

2021 ◽  
Author(s):  
Fatemeh Khoshoei Parizi ◽  
Tabandeh Sadeghi ◽  
Shahin Heidari
Keyword(s):  
Clinical Trial ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Pressure Ulcer ◽  
Ulcer Healing ◽  
Pressure Ulcers ◽  
Intervention Group ◽  
Well Being ◽  
Control Group ◽  
Significant Difference

Background & Aim: Pressure ulcers have been identified as one of the most important and challenging issues in patient’s well-being. Based on the evidence, rosemary extract compounds can affect wound healing. The aim of this study was to determine the effect of rosemary ointment on pressure ulcer healing in patients admitted to the intensive care unit. Methods & Materials: In this single-blind randomized parallel clinical trial, 70 patients who met the inclusion criteria were selected purposefully and assigned to the groups by stratified randomization method. In the intervention group, rosemary ointment was applied once a day for seven days. The control group received routine care. Data were collected using the Pressure Ulcer Scale for Healing before the intervention and on the third and seventh days after the intervention. Data were analyzed using independent t-test, chi-square test, and two-way repeated measurements ANOVA with SPSS 18 software. Results: The mean scores of Pressure Ulcer Scale for Healing decreased significantly in the intervention group while remained unchanged in the control group (P=0.001) one week after the intervention. The effect of time and interaction effect was also significant (P=0.001). Comparison of the ratio of complete ulcer healing in the two groups showed a significant difference between the two groups (p=0.004). Conclusion: Rosemary ointment facilitated healing and prevented the progression of grade І pressure ulcers in the Intensive Care Unit. Therefore, the use of this ointment as a low-risk, uncomplicated, available, and inexpensive intervention, is recommended in such patients.

scholarly journals Impact of Mild Hypothermia on Final Outcome of Patients with Acute Stroke: A Randomized Clinical Trial

2020 ◽  
Vol 17 (01) ◽  
pp. 17-23
Author(s):  
Abbas Rouzbahani ◽  
Esmail Khodadadi ◽  
Marjaneh Fooladi
Keyword(s):  
Clinical Trial ◽  
Acute Stroke ◽  
Randomized Clinical Trial ◽  
Mild Hypothermia ◽  
Intervention Group ◽  
Final Outcome ◽  
Control Group ◽  
Risk Of Death ◽  
Significant Difference ◽  
The Mean

Abstract Background and Aim Stroke is a sudden neurological disorder caused by disturbances in the brain blood flow and loss of normal brain function. Stroke is also the second leading cause of death worldwide. In the last two decades, among the various treatment options for stroke, hypothermia has shown the promise of improving the final outcome. This study aimed to investigate the effect of noninvasive hypothermia on the final outcome of patients with an acute stroke in Iran. Methods In a randomized clinical trial, 60 Iranian patients diagnosed with acute stroke were enrolled in 2018. Patients were selected by convenience sampling method and then randomized in two groups as experimental (n = 30) and control (n = 30). Mild hypothermia was applied using a cooling device for 72 hours on the patients’ heads and intervention results were compared with the control group. Data were collected by using Acute Physiology and Chronic Health Evaluation III (APACHE III), Full Outline of Un-Responsiveness (FOUR), and National Institutes of Health Stroke Scale (NIHSS), and later analyzed by Statistical Package for the Social Sciences (SPSS) software version 22. Results No significant difference was found in the mean scores of all three scales before and after the intervention in control group (p > 0.05) but statistically significant difference was found in the mean scores of all three scales for the intervention group (p < 0.05). The intervention group had an increased mean score in FOUR, while APACHE and NIHSS values dropped. Researchers found statistically significant difference between the mean scores after the intervention in the experimental group compared with the control group in all three scales (p < 0.05). Conclusion The findings of this study indicate that hypothermia has a significant statistical and clinical effect on the acute stroke outcome and it can be argued that hypothermia therapy can increase the level of consciousness and reduce the risk of death in stroke patients.

scholarly journals Knowledge and attitude of candidates to gastroplasty about perioperative: randomized clinical trial

2020 ◽  
Vol 73 (6) ◽  
Author(s):  
Lívia Moreira Barros ◽  
Francisca Antônia do Vale Gomes ◽  
Flávio Neves Carneiro ◽  
Nelson Miguel Galindo Neto ◽  
Natasha Marques Frota ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Educational Intervention ◽  
Intervention Group ◽  
Routine Care ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Vitamin Supplement ◽  
Significant Difference ◽  
Post Test ◽  
Knowledge And Attitude

ABSTRACT Objectives: to evaluate the effectiveness of educational intervention in the knowledge and attitude of candidates for gastroplasty. Methods: randomized controlled clinical trial with 56 preoperative patients (intervention=28; control=28). The control group received routine care from the health institution and the intervention group participated in a book-mediated educational intervention. Forms were used for clinical-epidemiological characterization and evaluation of knowledge/attitude about bariatric surgery, which were reapplied seven weeks after intervention. RBR-297fzx. Results: in the pre-test there was no significant difference between the groups (p=0.254). In the post-test, the group that received verbal guidance had a mean score of 19.5 (± 6.17) and the group reading the booklet averaged 31.1 (± 2.96), p=0.000. The attitude is adequate, especially for care such as vitamin supplement intake, water intake and physical activity practice. Conclusions: the educational intervention mediated by booklet was effective in improving knowledge and attitude when compared to verbal guidance. Thus, it can be replicated during the preoperative preparation.

scholarly journals Effects of fenugreek seed powder on stress-induced hyperglycemia and clinical outcomes in critically ill patients: A randomized clinical trial

2018 ◽  
Vol 5 (9) ◽  
pp. 2664-2670
Author(s):  
Akram Kooshki ◽  
Zaher Khazaei ◽  
Mojtaba Rad ◽  
Azam Zarghi ◽  
Akram Chanbari Mogaddam
Keyword(s):  
Clinical Trial ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Intervention Group ◽  
Routine Care ◽  
Wilcoxon Test ◽  
Apache Ii Score ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Fenugreek Seed

Introduction: Stress-induced hyperglycemia (SIH) is commonly observed in critically ill patients and associated with poor clinical outcome for patients. Fenugreek seed powder has long been known as an anti-diabetic drug since its pharmaceutical properties were demonstrated. Materials: The study herein was a parallel, randomized controlled clinical trial consisting of 60 adult patients randomly divided into 2 groups (n=30 per group). The study was conducted in Sabzevar, Iran in April 2015. The intervention group received 3 g of fenugreek seed powder by gavage, twice a day, in addition to routine care. The control group received only routine care. In the beginning, a daily evaluation of fasting and postprandial blood sugar was conducted for 10 days. Secondary components (prevalence of pneumonia; length of intensive care unit (ICU) stay, length of hospital stay, ventilator days, APACHE II score, and mortality rate) were measured until the time of hospital discharge or death. Data were analyzed via SPSS v.20 using Student's t-test (paired and unpaired), chi-square test, repeated measure ANOVA, and Wilcoxon test. Results: In during 10 days of treatment, there was a significant fall in mean glucose levels in 2 groups. However, this improve was more significant in Intervention group in compared to control group (p<0.001). Conclusion: The present study suggests that daily diet with fenugreek seeds can be used as an add-on therapy with other medications in the management of SIH in critically ill patients.

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