1 2383-4072 AJA University of Medical Sciences 126 Special The Effect of Triage Education by Pre Advance-Organizer Model on the Knowledge Staff Disaster Team Nurses Rostampour Mohammad Javad b kalroozi Fatemeh c Pishgooie Seyyed Amir Hosein d Aliyari Shahla e b MSc Student in Nursing of Intensive Care Nursing, Iran, Tehran, AJA University of Medical sciences Faculty of Nursing. c MSc in Nursing, Instructor, Iran, Tehran, AJA University of Medical Sciences Faculty of Nursing, Pediatric Department. d PhD in Nursing, Assistant Professor, Iran, Tehran, AJA University of Medical sciences Faculty of Nursing, Medical -Surgical Department. e PhD in Curriculum Studies, Assistant Professor, Iran, Tehran, AJA University of Medical Sciences Faculty of Nursing, Maternal Newborn Health Department. 1 12 2016 3 3 141 148 26 04 2016 06 09 2016 Introduction: In the event of health crisis, optimum performance crisis team personnel, are necessary and expected, and the key to success in managing the large number of victims with limited resources is triage; therefore triage training of crisis team nurses is very important. Objective: The purpose of this study was to determine the effect of triage education by pre-advance organizer model on knowledge of crisis team nurses at AJA selected hospitals. Materials and Methods: In this quasi-experimental study, during year 2015, two hospitals affiliated to the army, based on the centrality of the crisis, were considered as the study population and assigned to intervention and control groups, 50 nurses from the two hospitals were selected, based on available sampling. Educational content triage in crisis by the pre-advance organizer model in two sessions for an hour and a half was held for the experimental group while the control group did not receive any intervention. For both groups, pretest and post test tools, demographic questionnaire, and knowledge questionnaire were used. Finally data were analyzed by using descriptive analytic statistics using the SPSS version 22 software. Results: The results showed that the mean knowledge of nurses before the intervention in the experimental group was 8.66±1.65 and in the control group was 7.57±1.19, respectively (p=0/264) , and after the intervention, in the experimental group it increased to 15.66 ±1.02 and in the control group to 8.3±0.92; the independent T-test showed a difference between the two groups, which was statistically meaningful (P<0/001). Discussion and Conclusion: Considering the positive results, the use of pre-advance organizing model to promote awareness of crisis team nurses, and subject triage crisis training for faculty of nursing and retraining workshops are recommended.  
141 Special The Role of Spirituality on the Apparent Discipline and Spiritual Discipline of Staff of the Iranian Armed Forces Shahmoradi Mohammad Reza f Shaikhvaisi Yaser g f PhD Student for Women's Studies, Instructor, Iran, Tehran, Qom University of Religions and Denominations g PhD Student Social Issues Researcher, lecturer, AJA University of Medical Sciences, Faculty of Medicine, Epidemiology and Public Health Department. 1 12 2016 3 3 149 155 17 07 2016 29 10 2016 Introduction: In the recent decades interest in the consequences of spirituality among the staff of military organizations has increased; this involves areas affected by high levels of spirituality, increase physical and spiritual discipline employees. This study examined the role of spirituality on physical and spiritual discipline of staff of the armed forces of the Islamic Republic of Iran has accepted. Objective: This study aimed to examine the role of spirituality in the spiritual discipline of staff of the armed forces of the Islamic Republic of Iran. Materials and Methods: This study was a survey and the sample size consisted of 390 employees of the armed forces that were selected by stratified random sampling method. The research was carried out during year 2015 and was used to measure spirituality of employees, using the Piedmont scale. In order to assess the reliability of the questionnaire Cronbach›s alpha coefficient and test retest methods were used, and to test the hypotheses, Kendall and Spearman correlation coefficient and multivariate regression were used. Results: The results indicated a significant relationship between variables of spirituality and physical and spiritual discipline of the armed forces personnel and confirmed both hypotheses (influence of spirituality on physical discipline and spirituality). Discussion and Conclusion: The test results between spirituality and physical discipline (t=4/395 & P< 0/05) and spirituality and spiritual discipline (t=5/465 & P<0/01) of armed forces personnel and research hypothesis was confirmed by both parties. 140 Special Comparison of Intermittent and Bolus Feeding on Pulmonary Aspiration in Patients With Sepsis, Hospitalized at Intensive Care Units: A Triple Blind Randomized Controlled Trial Ahangari Mojtaba h Farsi Zahra i Dadgari Fahimeh j h MSc Student in Critical Care Nursing, Iran, Tehran, AJA University of Medical Sciences, Faculty of Nursing. i PhD in Nursing, Associate Professor, Iran, Tehran, AJA University of Medical Sciences, Faculty of Nursing, Community Health Department j MSc in Nursing, Instructor, Iran, Tehran, AJA University of Medical Sciences, Faculty of Nursing, Psychiatric Nursing Department 1 12 2016 3 3 156 164 22 06 2016 06 08 2016 Introduction: Nutrition is a basic human need and a great challenge at intensive care units. Studies have shown that unsuitable nutrition can be a risk factor for many complications including aspiration. Objective: The purpose of this study was to compare two methods of bolus and intermittent feeding on aspiration in patients with sepsis, hospitalized at intensive care units. Materials and Methods: This study was a triple blind randomized controlled trial that was performed on 60 patients with sepsis, hospitalized at the intensive care units of Chamran Hospital, Tehran, Iran, for three days, during years 2015 and 2016. Patients were divided to three groups (bolus feeding, intermittent feeding and control). Methylene blue solution was used to evaluate pulmonary aspiration of the patients. Therefore, aspiration was emphasized with suctioning of the respiratory tract and assessing lung secretions in terms of blue color of methylene blue solution. The SPSS (version 22) software was used to analyze the data. Results: The Kruskal-Wallis test indicated no significant difference between groups in terms of frequency of aspiration in three days (P>0.05). Friedman and Cochran tests also showed no significant difference in pulmonary aspiration during the three consecutive days in each of the groups (P>0.05). Discussion and conclusions: The present study showed no significant difference among the three groups (bolus feeding, intermittent feeding and routine) in terms of aspiration. More studies with larger sample sizes during longer period are suggested. Keywords: Aspiration, Bolus Feeding, Intensive Care Unit, Intermittent Feeding, Sepsis. 121 Special Comparison of Job Stress and Job Satisfaction Amongst Nurses of Different Units Moallemi Sedigheh k Adroom Mahdiyeh l k MSC in Psychology, Iran, Zahedan, Zahedan University of Medical Sciences. l MSc in Psychology, Iran, Zahedan, Zahedan University of Medical Sciences. 1 12 2016 3 3 165 173 28 02 2016 13 08 2016 Introduction: Occupational stress and low job satisfaction are key factors in reducing staff productivity in organizations with physical and psychological impacts on employees. Nursing is amongst the most stressful professions. Objective: This study aimed to determine the difference between job stress and job satisfaction among nurses of four internal departments, intensive care emergency and surgery units. Materials and Methods: This descriptive study included 103 nurses selected from hospitals of Zahedan University of Medical Sciences and Hospital of Social Security Organization during year 2014, by random sampling. The Nursing Stress Scale (NSS-57) and Job Satisfaction Questionnaire were used. The hypotheses were tested using one-way Analysis of Variance (ANOVA) and Lease Significant Difference (LSD). Results: According to the results of the current study, there was a significant difference between the nurses› job stress in different units and several subscales (P ≤ 0.05). The highest measure was related to death and dying subscale (2.24) , workload (2.21) and certainty concerning treatment (2.20) , respectively and the lowest correlation was with discrimination (1.34). The results showed there was no significant difference between the nurses› job satisfaction at different units (P = 0.64).The nurses of internal department and emergency had high level of stress in total score and most of the subscales of stress (job satisfaction = 17.56, nursing stress = 57.89). Discussion and Conclusion: Counseling sessions for nurses, on how to deal with a patient›s death (the highest score) can be useful. It is currently crucial to pay attention to emergency department nurses. To set the amount of work for nurses, and organize sufficient education in internship courses can be useful to reduce stress. 142 Special The Implementation of Family-Centered Empowerment Model on the Empowerment Parameters of Patients With Prosthetic Heart Valves Abedini Fahimeh m Zareiyan Armin n Alhani Fatemeh o Teimouri Fatemeh p m MSc Student in Critical Care Nursing, Iran, Tehran, AJA University of Medical Sciences, Faculty of Nursing. n PhD in Nursing Education, Assistant Professor, Iran, Tehran, AJA University of Medical Sciences, Faculty of Nursing, Health Department. o PhD in Health Education, Associate Professor, Iran, Tehran, Tarbiat Modares University, Faculty Medical, Nursing Department. p MSc in Nursing, Instructor, Iran, Tehran, AJA University of Medical Sciences, Faculty of Nursing, Pediatric Department. 1 12 2016 3 3 174 183 18 07 2016 06 09 2016 Introduction: After heart surgery, patients are at risk of multiple problems and concerns. It is essential to prepare them to continue living with the chronic nature of the disease. Empowerment is one of functional and low-cost methods. Objectives: The aim of this study was to assess the effect of family-centered empowerment model on empowerment parameters in patients with artificial heart valves. Materials and Methods: This clinical trial study was done during year 2015. After the patient was transferred from the Intensive Care Unit (ICU) , the test group and control group were selected by the available sampling method. For the test group, the family-centered empowerment model was performed in four steps: threat perceived, self-efficacy, self-esteem and evaluation through group training, group problem solving and educational participation during three to five sessions. Educational cards and booklets were provided for the cases and an active member of their family. The control group received routine care. Patient capability indexes (threat perceived, self-efficacy and self-esteem) was evaluated before, immediately after the intervention and one and half months after the intervention. The data was analyzed by SPSS version 23 software. Results: Both groups were similar before the intervention in terms of demographic variables. The level of empowerment of the two groups before the intervention, in all three areas was not significantly different, but after the intervention, the test group’s level of empowerment was significantly improved in all three areas (P<0.05). After one and half months the ability was not only stable but had also increased. Discussion and Conclusion: Based on the findings, implementation of the model and nursing interventions as part of the family-centered empowerment model improved the empowerment parameters of patients with prosthetic heart valve. 130 Special The effect of standard and routine endotracheal suctioning on hemodynamic indexes of patients admitted to the intensive care unit of AJA selected hospital Zarea foroogh Pishgooie Seyyed Amir Hosein Roshandel Maryam MSc Student of Critical Care Nursing, Iran, Tehran, AJA University of Medical Sciences, Faculty of Nursing PhD in Nursing, Assistant Professor, Iran, Tehran, AJA University of Medical Sciences, Faculty of Nursing, Medical-Surgical Department. MSc in Nursing, Iran, Tehran, Instructor, Iran, Tehran, AJA University of Medical Sciences, Faculty of Nursing, Community Health Department. 1 12 2016 3 3 185 191 03 05 2016 16 09 2016 Introduction: Suctioning the airways through an endotracheal tube is an important intervention to manage patients under mechanical ventilation, which is usually performed by nurses and if not accomplished properly, it can cause lots of side-effects. Objectives: The aim of this research was to determine the effects of standard and routine endotracheal suctioning on hemodynamic indexes of patients admitted to intensive care unit. Materials and Methods: This was a clinical trial conducted at Besat hospital in Tehran in 2015. After preparing the instruction of standard suction by the researcher and validity confirmation, standard suction (by researcher) , and in the second turn routine suction (by the nurse of patient) , or conversely was performed for 36 patients considering their needs, randomly by tossing coin. HR, O2Sat and PIP were recorded just before and immediately, 5, 10 and 15 minutes after the procedure. Data were analyzed with independent t-test and ANOVA with repeated measurement. Results: there was no significant difference in the mean O2Sat between the two groups before the procedure, but a significant increase was observed immediately, 5, 10 and 15 minutes after the standard procedure. HR and PIP did not change significantly between the two groups. Discussion and Conclusion: considering the necessity of endotracheal suctioning for cleaning the secretions, by performing it in a correct way, conducting hyper-oxygenation before suctioning for 30-60 seconds and after that for one minute, reducing its time to less than 15 seconds, and using a catheter with a diameter less than the half of endotracheal internal diameter, we can reduce the side-effects, as well as preventing hypoxia in patient. 143 Special Designing and Implementation of Evaluation Checklist for Students’ Educational Performance Farsi Zahra PhD in Nursing, Associate Professor, Iran, Tehran, AJA University of Medical Sciences, Faculty of Nursing, Community Health Department. 1 12 2016 3 3 192 203 09 08 2016 24 09 2016 Introduction: Due to the key importance of tests in achieving optimal quality of educational processes and their essential role in creating favorable changes in knowledge, attitude and practice of students toward educational processes including patient education, development and implementation of tools with comprehensive overview of the evaluation of learners is essential and contributes to the improvement of their performance in different fields. Objectives: The aim of this study was to design and implement a checklist to evaluate educational activities of students in patient education course. Materials and Methods: This study was performed with methodological approach during 2013-2016. A checklist with eight dimensions was designed to evaluate students’ educational performance. Face and content validity of the checklist was confirmed. In order to confirm the reliability of tools, an agreement between the two raters was used. Kappa formula was used to examine the contingency coefficient of questions which varied between 0.7 and 1, indicating an excellent agreement between the two raters. The internal consistency of checklist (α = 0.8) was approved. Results: The main dimensions of checklist included designing lesson plans to teach students/patients and clients (15 items) , quality of presentation (17 items) , quality of modern teaching methods (role-modelling) (10 items) , quality of educational scenario (6 items) , quality of teamwork of learners (8 items) , quality of teaching aids (slides provided in the PowerPoint software (12 items) , poster, pamphlet, booklets (16 items)) and quality of media and social networks (Blog, Telegram, Instagram) (16 items) used in the educational process by students. Discussion and Conclusion: Having a holistic and comprehensive vision to develop evaluation tools of educational activities can be an effective step towards achieving the goals of education. Further research in other educational settings by using the designed tool and assessing its generalization is suggested. 132 General Studying Ebola and Crimean Congo hemorrhagic fevers and the role of self-protection Education in infection prevention Seyedi Roghaye Sharififar Simin taj Zareiyan Armin MSc Student in Nursing Military, Iran, Tehran, AJA University of Medical Sciences, Faculty of Nursing. MSc in Nursing, Instructor, Iran, Tehran, AJA University of Medical Sciences, Faculty of Nursing, Community Health Department. PhD in Nursing Education, Assistant Professor, Iran, Tehran, AJA University of Medical Sciences, Faculty of Nursing, Health Department. 1 12 2016 3 3 204 212 25 05 2016 31 07 2016 Introduction: Viral hemorrhagic fevers are a kind of zoonotic infectious diseases. They have clinical symptoms such as: fever, myalgia, weakness, paralysis, hemorrhage, and in some cases hypotension, shock and death. Among Viral hemorrhagic fevers, Ebola is the most terrible disease. Objectives: The purpose of this research was a review of studies on the causes of hemorrhagic fevers outbreaks and epidemics regarding Ebola and Crimean-Congo hemorrhagic fevers. Materials and Methods: This was a review study based on internal and external search in databases such as PubMed, Google Scholar and SID, as well as search sites of WHO and CDC from 2001 to 2016. Results: In this paper, two important diseases of hemorrhagic fever, Ebola and Crimean Congo, have been explained. It also talks about the biggest epidemic of Ebola in its history in the recent years as well as Crimean Congo hemorrhagic fever as an endemic disease in Iran. A number of people die from Crimean Congo hemorrhagic fever annually in Iran. Discussion and Conclusion: The agents of hemorrhagic fevers are important for public health. These agents have the ability to extensively spread in natural outbreaks. They infect a mass population, and a large number of patients are health care providers. For success in controlling the outbreak of hemorrhagic fevers, it needs to interrupt the cycle of transmission. Therefore, self-protection education among health care providers is very important.