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Background & Objective: Error Board Reporting (EBR) is a comprehensive approach for quickly reporting and analyzing errors that occur during surgical operations. This study assesses the influence of EBR on student error frequency and proficiency during the COVID-19 pandemic, with the goal of enhancing clinical teaching. Material & Methods: This research used an experimental design that included a pretest and posttest to investigate the impact of the intervention on two distinct groups: the intervention group receiving EBR training and the control group undergoing conventional training. The participants were randomized to either EBR or conventional training. Both groups had pretests and posttests, with logbook results included as part of the final assessment process. Furthermore, a satisfaction survey was conducted after the study to gauge participant satisfaction levels. The data gathered from this study underwent rigorous statistical analysis employing various tests, including the Shapiro-Wilk test for assessing normality, the independent t-test for comparing across groups, the paired t-test for comparing within-groups, and multiple linear regression analysis. Results: The study found no statistically significant differences in age, gender, semester, or age between the intervention and control groups. Furthermore, these characteristics did not have a significant influence on the final scores. However, posttest results and scores from post-practicum logbooks demonstrated significant differences between the two groups (p < 0.001 and p = 0.002, respectively). EBR training significantly improved surgical procedural mastery skills (p = 0.002) and self-efficacy (p = 0.001). A paired t-test demonstrated a statistically significant difference between the two groups regarding their mean pretest and posttest scores (p < 0.001). EBR decreased student errors 86% of the time, effectively promoted a positive spirit, improved critical thinking, and strengthened critical thinking skills (76%). Conclusion: Incorporating EBR into educational practices can minimize errors and enhance performance during the COVID-19 pandemic, increasing patients' quality of life.

Background: Human T-cell Leukemia Virus type-1 (HTLV-1) -associated myelopathy causes sufferers to experience changes in several aspects of their lives. Gaining a deeper understanding of these changes can help healthcare professionals improve care, enhance strategic decision-making, meet expectations, and manage patients effectively. However, there is no information about the experience and problems of patients with HTLV-1-associated myelopathy/tropical spastic paraparesis in Iran. Therefore, this study aimed to explain the lived experience of patients with HTLV-1-associated myelopathy/tropical spastic paraparesis.Methods: This qualitative study used hermeneutic phenomenology in 2022 in Mashhad, Iran. Participants were selected using purposeful sampling. Data were collected through 21 semi-structured in-depth interviews with 20 eligible patients with HTLV-1-associated myelopathy/tropical spastic paraparesis. The data were analyzed in MAXQDA/2020 using the six stages proposed by Van Manen. Results: The main concept of “Reduced self-sufficiency and social dignity” emerged from the narratives of the patients, which included three main categories: “Disruption of desirable personal and social life”, “reduced perception of role competencies”, and “obligatory unpleasant lifestyle changes”.Conclusion: HTLV-1-associated myelopathy/tropical spastic paraparesis slowly makes patients feel insufficient and causes a sense of degradation in dignity. The disease can fundamentally change personal and social life. Thus, due to its incurability and progressiveness, palliative care should be provided to them to live with dignity.

Introduction: Providing psychological support is one of the traditional roles of nurses for patients with HIV/AIDS. Searching the literature showed that various psychological interventions have been performed by nurses to support HIV/AIDS patients; however, no summary of these interventions is available. We aimed to systematically review the interventional studies which investigated the effectiveness of psychosocial interventions delivered by nurses to HIV/AIDS patients. Methods: This systematic review was performed based on Cochrane’s handbook of systematic reviews of interventional studies. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement were used in this study. The databases of PubMed, Web of Science, Cochrane, Scopus and World Health Organization were searched from January 2009 to December 2022. Based on inclusion criteria, nine studies included in this systematic review. Cochrane data extraction form was used for the systematic review and the article’s information was summarized using the modified Jadad scale. Results: The interventions provided by the nurses included: virtual and face-to-face educational programs, written information resources, palliative care, motivational interview, case management, home visit, and care services, along with face-to-face and telephone follow-up. These interventions have a significant positive effect on the quality of life and management of high-risk behaviors, disease management, symptoms and complications, adherence to treatment, immune function, and mental health in patients with HIV/AIDS. Conclusion: The results of the present study show that despite the fact that the interventions have a purely psychological content and can be done with various methods, they are able to have positive consequences in physical, psychological, behavioral, and laboratory health in HIV/AIDS patients.

Background: Caring for patients with brain death diagnosis is the heaviest of duties for nurses, and, due to the complexities and stressors, it is the biggest challenge of nursing in an intensive care unit. Objective: This qualitative research aimed to disclose the nurses' experience of caring for brain-dead patients. Methods: The present study was a qualitative research using a content analysis, where the data collection process included 21 semi-structured and in-depth interviews with intensive care nurses, physicians, head nurses, a transplantation committee coordinator, and the authority of the organ procurement unit. Adequate data were collected from March 2014 until the saturation point was reached in June 2016. Data were analyzed simultaneously with data collection using qualitative content analysis with a conventional approach. Results: Qualitative content analysis of data resulted in two themes and eight subthemes, reflecting the analysis of nurses' experiences of caring for brain-dead patients. The themes included "Challenges of right and duty requirement,” and "turbulent confrontation with successive chains of tension". Finally, the main themes of "resonance of stress and internal conflict in care" were abstracted. Conclusion: The findings deepened our understanding and knowledge of the issue. Despite all the stress, nurses care for potential organ donors, and this results in preserving the organs’ viability for donation. Nurses' problems and challenges in this caring process should be considered by policymakers of health and treatment systems and a supportive model be designed for nurses in the intensive care unit.

Introduction: Stroke is the most common debilitating neurological disease in adults. Therefore, rehabilitation is a major consideration to reduce costs and relief disabilities. Biofeedback, a newly recommended method is claimed to be able to improve the consequences following stroke by enhancing the understanding of the psychological functions of the body. The purpose of this study was to investigate the effects of biofeedback on the motor– muscular situation in balance and ability to walk, muscle stiffness (spasticity), hand muscles strength of stroke patients. Methods: The present study was a randomized clinical trial done in 2016. The participants were randomly divided into 2 groups (case and control group). In the intervention group, biofeedback was performed. The check list of main variables, including balance and ability to walk, muscle stiffness (spasticity) and hand muscles strength was completed by a physician before the intervention and at the end of the intervention (16th session). The statistical analysis was conducted, using SPSS version 13. Results: The mean score of balance in intervention group versus control group showed significant differences. The results showed that by eliminating the effects of muscular strength before the intervention, this variable had made improvements and significant differences in both intervention and control groups after the intervention. Comparison of the average spasticity showed that spasticity evaluation score before and after the intervention revealed no significant difference between the two groups. Conclusion: Biofeedback therapy is a promising treatment modality for improving the motor–muscular situation of patients after stroke.

Evaluation is a principle of educational processes Comprehensive examination is one of evaluation types that is recently considered in undergraduate nursing, but its structure has not been specified and universities are responsible for examining it. The aim of this study is to design a comprehensive and practical test for undergraduate nursing students. Methods: This modified classic Delphi method was conducted in two stages in 2016. The participants were academics of the nursing and midwife school, educational supervisors, head nurses, nurses and students of Mashhad University of Medical Sciences. Thirty six participants were selected based on major purpose. The first part was designed in order to extract indexes and components of comprehensive examination by literature review and deep interviews after a comprehensive examination was codified in three rounds (face to face and online). The collected data were analyzed based on the percentage of agreement and IQR methods. Result: In this study, the framework of the comprehensive test was codified based on four sections including content, assessment methods, holding conditions of exam and acceptance criteria. Content was included adult and elderly nursing courses, pediatric nursing, maternal and child health, family health nursing, psychiatry and ethics. The OSCE and DOPS methods were determined as the most appropriate method for evaluating clinical skills. Passing mark was considered 14/20. In addition, other criteria for acceptance and rejection, appropriate examination centers, duration, execution time and implementation team. Conclusion: Indices comprehensive test have been adjusted according to the perspectives of nursing and education experts, global trends and local conditions can be used for the nursing and midwife School in order to facilitate accessing desired goals in this evaluation. Keywords: Examination, Final Examination, Evaluation, Clinical Competence, Nursing, Delphi Technique

Background: Nurses in intensive care units (ICU) play a key role in taking care of brain dead patients and they are often in contact with such patients given the high rate of brain deaths. Consequently, they are in a challenging and stressful condition, which may be aggravated due to the need for increased organ donation, and this may also affect the quality of care provided for these patients. Objective: This review analyzes the different studies on the concept of brain death from both medical and legal points of view. The aim of this study was to identify the challenges the nurses face with the perception of the concept of brain death and its effects on the care provided for the patients suffering from brain death, as well as organ donation. Methods: This Narrative review study summarizes the information obtained from relevant literature through a targeted search of library texts and electronic resources including Science Direct, PubMed, Google Scholar, Scientific Information Database (SID), IranMedex, and Magiran databases during 2000-2017 in English and Persian, on the subject of interest by keywords such as brain death, organ donation, care, legal, regulations and nursing. Finally, a total of 44 relevant articles were reviewed. Results: Nurses play an important role in taking care of brain dead patients; therefore, recognizing challenges can be the first step in taking accurate care of these patients and subsequently maintaining the organs’ health for transplants. Although there are clinical and legal uncertainties regarding the concept of brain death, nurses have an important effect on taking care of brain dead patients as well as the rate of organ donation. Conclusion: Nurses in intensive care units should have a clear understanding of the concept of brain death in order to be able to take care of brain dead patients by avoiding psychological effects. In this regard, it is recommended that a comprehensive educational program be designed on the dimensions of brain death. Therefore, the nurses' awareness of brain death and their ability to clarify this concept to the patients' relatives would have a great effect on the decrease in the challenges and the stress imposed on the nurses. Also, there would be an increase in the quality of the care given to brain dead patients and even the rate of organ donation.

Background: Patients undergoing mechanical ventilation in intensive care units are in a special position of suffering, and discovering their experiences in the painful situations of the intensive care unit can contribute greatly to improve the quality of nursing care for them. Objective: The present study was performed aiming to explain the experience of conscious patients receiving mechanical ventilation in the intensive care units of the causes of suffering. Methods: This is a qualitative content analysis study conducted in Iran in 2017. Participants of this study included 15 conscious mechanically ventilated patients in the intensive care unit. Semi-structured interviews and observations were used to collect data. For sampling, first, the purposeful and then theoretical methods (guided by the created categories) were used and the procedure continued until saturation of the data. The text of the handwritten notes of recorded interviews were analyzed using conventional qualitative content analysis. Results: Four subclasses of "unpleasant consequences of disease", "bitter elixir of therapy", "an inconvenient environment" and "understanding the threat to family safety and comfort" all under the general category "enclosed in the synergistic rings of suffering" were extracted from the profound descriptions of contributors. Conclusion: Mechanically ventilated patients in the intensive care unit are enclosed in the rings of suffering, so that each of these rings imposes a great deal of pain and suffering on the patient and have a synergic and intensifying effect on each other. Therefore, design and application of strategies and nursing care is essential to reduce the severity of the suffering and discomfort of these patients.

Introduction: Nurses play a key role in the process of organ donation and transplantation, and previous studies have widely addressed the level of knowledge and attitude of intensive care unit (ICU) nurses in this regard. Considering the direct correlation between the positive attitude of the healthcare team, especially nurses, and the level of consent on organ donation, knowledge and attitude of nurses are important factors that have been assessed in several studies. However, no definite conclusions have been drawn in this regard. The present study aimed to evaluate the knowledge and attitude of ICU nurses toward organ donation and the related factors.Methods: A systematic review was conducted via searching in databases such as ProQuest, Medscape, MedlinePlus, MagIran, PubMed, and ScienceDirect to identify the articles published during 1990-2015 using keywords such as knowledge, attitude, organ donation, and nurses.Result: Awareness and knowledge are the main determinants of attitude in nurses, which should be applied in order to foster positive attitudes in the process of organ donation. Furthermore, extensive clinical knowledge should be acquired on organ donation and communication skills by ICU nurses through proper training programs.Conclusion: According to the results, using standard guidelines or scheduled training programs in nursing schools could improve the level of knowledge in nurses, which in turn enhances nursing performance. In addition, our findings indicated that positive attitude and knowledge of nurses could largely infleunce the viewpoint of families toward organ donation.

Background: The unlearning process is complex and sometimes painful in nature. This process usually occurs in social interactions and is very dependent on social contexts and the work environment. Objective: To explore the concerns and mental challenges in facing unlearning situations in nurses. Methods: This qualitative study using content analysis was conducted in 2013-2015. Participants were 25 people, and research environment was hospitals in Mashhad and Gonabad. The method of data collection was unstructured interview, and sampling was continued until data saturation. First, the recorded interviews were transcribed and reviewed several times. Then open codes were extracted and after reviewing several times, were classified into subcategories based on semantic similarity. Finally, the similar subcategories were put into the main categories semantically. Results: Data analysis led to the emergence of 1,180 initial codes and 8 categories and 3 themes. Our themes were discouraging/encouraging situation, double-edged sword colleagues, and organizational policies paradox, that the central theme of progressive and suppressor organizational climate paradox were derived from them. Conclusion: Exposure to unlearning situations is a complex process of which its adoption and implementation is difficult and challenging. This suggests that supporting nurses and attention to their mental concerns and providing favorable learning conditions is required

Objective (s): To explore various effective factors relevant to the decision for organ donation of Brain-Death patient’s family.Method: This study is a qualitative research with its focus on the content analysis approach. Data collection process included 38unstructured in- depth interviews with 14 Brain-Death patient's families (totaling 34 participants) who announced their consent to donate their patient’s organ and so with 12 families who refused from organ donation and field notes. Sampling method begun as purposive in transplantation management center in Mashhad University of medical science - October 2009 -and continued until data saturation occurred in December 2010. Results: Qualitative content analyses of interviews and filed notes resulted to six main themes were extracted from the current dataset that showed the most important factors which influenced family’s decision making process These were included: brain death acceptance, cognitive preparation,confrontation's quality and time, decision makeing mediators', familial interactions, bleives and motivators.Conclusion: The results showed a number of factors are influential in organ donation that Discovering and explaining these factors help policy makers and administrators to planing and interventions in relation to culture-building and facilitate organ donation. Also recommended medical team team ensure families understand the concept of brain death and its irreversibility and give thems clear and complete information.