2026-08-08T14:05:45+03:30 http://jccs.yums.ac.ir/browse.php?mag_id=23&slc_lang=en&sid=1

23-286 2026-08-08 10.1002

Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2024 5 4 J. Begjani N. Bagheri Moheb Sh. Haghani H. Babaei Aims: Insufficient nursing qualifications are among the factors contributing to clinical errors in care units. Additionally, frequent false alarms diminish nurses' trust in alarm systems and delay response times, potentially leading to alarm fatigue over time. This study aimed to investigate the association between alarm fatigue and clinical competence among neonatal intensive care unit (NICU) nurses. Instruments & Methods: This descriptive correlational study included 140 NICU nurses from Kermanshah, Iran, during 2023-2024, selected using a census sampling method. Data collection tools comprised a demographic questionnaire, the "Nurse Competence Scale," and the "Alarm Fatigue Questionnaire." Statistical analysis was conducted using SPSS version 16, employing both descriptive and inferential methods, with a significance level set at p<0.05. Findings: The mean alarm fatigue score was 21.61±7.45, indicating a level above average. Most participants (75%) demonstrated very good clinical qualifications. The average clinical competence score was 174.76±26.74, also rated at a very good level. A significant relationship was observed between alarm fatigue and clinical competence in the teaching-coaching subscale (p=0.019). However, no significant association was found overall. Conclusion: As alarm fatigue increases, clinical competence specifically within the teaching-coaching subscale declines. However, no significant correlation is observed between overall clinical competence (excluding the teaching-coaching subscale) and alarm fatigue, nor between alarm fatigue and the individual subscales of clinical competence. Nurses Alert Fatigue Health Personnel Clinical Competence Intensive Care Units Neonate 2024 10 01 173 179 http://jccs.yums.ac.ir/article-1-286-en.pdf 10.58209/jccs.5.4.173

23-295 2026-08-08 10.1002

Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2024 5 4 L. Mostafavi A. Bagheri Fard Z. Rahami Aims: Considering the important role of sexual dysfunction and decreased sexual function of patients with diabetes, the purpose of this study was to investigate the effect of soft gelatin capsules of ginseng as an herbal medicine on sexual function in patients with diabetes. Materials & Methods: In this double-blind controlled clinical trial with a control group, 80 patients with diabetes (type 1 and 2) were selected using the convenience sampling method, and randomly allocated to two groups of control and intervention groups (each 40 people). The effect of 100 to 200 mg of ginseng soft gelatin capsules (daily for 8 weeks) on the sexual function of men and women with diabetes in the intervention group and a similar placebo in the control group were studied. The Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF) were used for gathering data before and at the end of 8 weeks of intervention. Data were analyzed using SPSS 16 software. Findings: At the beginning of the study, the mean score of the IIEF index in the control and intervention groups was 28.08±5.93 and 30.73±8.15, respectively without significant change (p=0.199). Eight weeks after the intervention, the IIEF index significantly improved in the group receiving ginseng 44.95±7.64 as compared to the control group 27.81±6.02 (p<0.001). At the baseline, the mean score of the FSFI index in the control and intervention groups were 47.36±5.93 and 46.06±5.47, respectively (p=0.525). At the end of the study, the FSFI index significantly improved in the group receiving ginseng 66.17±5.63 as compared to the control group 47.21±8.41 (p<0.001). Conclusion: The consumption of ginseng for 8 weeks had a significant effect on the improvement of the sexual function of male and female diabetic patients. Ginseng Sexual Activity Diabetes 2024 10 01 181 187 http://jccs.yums.ac.ir/article-1-295-en.pdf 10.58209/jccs.5.4.181

23-299 2026-08-08 10.1002

Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2024 5 4 M.B. Jahantab A. Mohsenpour Sh. Salaminia S. Mehrabi Sisakht N. Roustaei J.M. Malekzadeh M.J. Yavari Barhaghtalab Aims: Intraperitoneal CO2 insufflation appears to be a risk factor for alterations in coagulation and liver function tests (LFT) following laparoscopic cholecystectomy. Therefore, the present study was conducted with the aim of comparing the effect of low-pressure CO2 intraperitoneal insufflation (12-15 mmHg), and high-pressure CO2 intraperitoneal insufflation (16-20 mmHg) on the patient's coagulation status and liver function test after laparoscopic cholecystectomy. Materials & Methods: This randomized clinical trial consisted of 150 patients who were candidates for laparoscopic cholecystectomy and referred to Shahid Beheshti and Shahid Jalil Hospitals affiliated with Yasuj University of Medical Sciences, Iran in 2022-2023. They were selected using the convenience sampling method and allocated to two different CO2 insufflation pressure levels, either 12-15 or 16-20 mmHg by random sampling method (75 patients each). Coagulation profile including prothrombin time (PT), partial thromboplastin time (PTT), international normalized ratio (INR), bleeding time (BT), and liver function tests such as AST (Aspartate Aminotransferase), ALT (Alanine Transaminase), ALP (Alkaline Phosphatase), total bilirubin (T.bili), and direct bilirubin (D.bili) were measured and recorded in the night before the operation and 24 hours after the operation. The data was analyzed by SPSS 16 (p-value<0.05). Findings: There was a significant increase in PT (p=0.035), and a decrease in BT (p=0.0001) in the group with pressure levels of 16-20 compared to 12-15 mmHg after the intervention. Conclusion: The level of intraperitoneal CO2 insufflation has no effect on coagulation and liver. Therefore, CO2 pressure of 12-20 can be used safely in laparoscopic cholecystectomy surgeries.   Carbon Dioxide Insufflation Blood Coagulation Factor Liver Function Test Laparoscopic Cholecystectomy 2024 10 01 189 195 http://jccs.yums.ac.ir/article-1-299-en.pdf 10.58209/jccs.5.4.189

23-298 2026-08-08 10.1002

Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2024 5 4 Z. Shabanikordsholi M. Safari S. Parvizi P. Shabanikordsholi Aims: Skin-to-skin contact between mother and newborn is a crucial component of maternal and newborn care, promoting breastfeeding and bonding. This study aimed to identify the barriers to implementing skin-to-skin contact guidelines at birth from the perspective of midwives working in hospitals in Yasuj, Iran. Instrument & Methods: This descriptive cross-sectional study involved 88 midwives employed at two hospitals in Yasuj in 2024. Data were collected through interviews using a questionnaire comprising two sections: demographic characteristics and questions addressing seven categories of barriers to implementing the skin-to-skin contact guideline. The questionnaire’s validity was assessed using the Content Validity Index. Data were analyzed using descriptive statistics, including frequency tables and central and dispersion indices, with SPSS version 16 software. Findings: The midwives’ ages ranged from 25 to 59 years, with a mean of 35.91±8.482 years. Their work experience in maternity hospitals ranged from 1 to 26 years, with a mean of 6.672±6.68 years. According to 48 midwives (54.5%), skin-to-skin contact in the hospital was not performed according to the guidelines. The identified barriers were midwives' knowledge barriers (4.5%), human resource barriers (39.8%), environmental barriers (4.5%), content-related barriers in the guideline (2.3%), maternal and newborn safety barriers (17%), cultural barriers (5.7%), and managerial and supervisory barriers (19.3%). Conclusion: The primary barriers to implementing the skin-to-skin contact guideline at birth are human resource limitations, managerial and supervisory issues, and concerns related to maternal and newborn safety. Skin Infant Newborn Mothers Midwifery 2024 10 01 197 205 http://jccs.yums.ac.ir/article-1-298-en.pdf 10.58209/jccs.5.4.197

23-290 2026-08-08 10.1002

Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2024 5 4 M. Yeganeh H. Ahmadi F. salmani Sh. Goli Aims: Drug interactions include chemical reactions that often occur between two or more drugs or even when a drug is taken with food, drink, or a supplement. Therefore, the aim of this current review is the determine potential drug interactions in the intensive care unit and the role of nurses in their prevention. Information & Methods: This is an integrated review. Our available sources include all studies conducted on drug interactions in elderly care units between 2012 and 2024 that are included in this study. The databases searched include: CINAHL, Scopus, PubMed, Cochrane Database of Systematic Reviews, Wiley, Science Direct, Iran Medex, Scientific Information Database (SID), and Google Scholar. The Persian-English keywords were "drug interactions", "potential drug interactions", “adverse events", “intensive care units", “critically units", “risk of drug coexistence”, “drug accident”, “adult” and “elderly”. Findings: Using the relevant keywords, 34 studies were found. 17 articles were excluded due to the lack of relevance to the topic and unavailability of the full text of the article. Finally, 12 valid articles were confirmed, of which 6 were Persian articles and 6 were in English. Conclusion: Drug interactions have a direct relationship with low Apgar scores, age, long-term stays in the department, and the number of doctors. Phenytoin, phenobarbital, and fentanyl are identified as the most interfering in the department. Drug Interaction Prevalence Drug Interactions Intensive Care Units 2024 10 01 207 213 http://jccs.yums.ac.ir/article-1-290-en.pdf 10.58209/jccs.5.4.207

23-303 2026-08-08 10.1002

Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2024 5 4 M. Seyed-Nezhad O. Yousefianzadeh M.S. Mirzaee M. Moradi-Joo Aims: In the ever-evolving healthcare landscape, nurses are at the forefront of patient care. Nurses’ procedural skills are the lifeblood of quality care. Artificial Intelligence (AI) is a useful game changer that can change how we approach nursing practice. This scoping review was conducted with the aim of determining the potential of AI in improving nurses’ clinical, educational, decision-making, informational, and research skills. Information & Methods: Eight electronic databases (PubMed, Scopus, Web of Science, Embase, CINAHL, ProQuest, Microsoft Academic, and OpenGrey) were searched to find all studies (peer-reviewed and grey literature) published up to September 2024 using the keywords AI, nursing skills, and related terms. The Google Scholar search engine was used to find relevant sources and complete the search coverage. Data collected from included studies on each role that AI could play in nurses' skills were analyzed using narrative methods. Findings: Finally, 30 review studies were included. Accordingly, AI has a beneficial effect on six main themes (education, decision, clinical practice, research, information, and psychiatric nursing) and 33 subthemes. Conclusion: AI plays a fundamental role in improving the clinical, educational, decision-making, informational, and research skills of nurses. Artificial Intelligence Nurse Education Decision Making Research Psychiatry 2024 10 01 215 224 http://jccs.yums.ac.ir/article-1-303-en.pdf 10.58209/jccs.5.4.215

23-226 2026-08-08 10.1002

Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2024 5 4 H. Arianpour M. Hosseini A. Afrasiabifar J.M. Malekzadeh Aims: Sleep disorders are common in acute coronary syndrome. Benson relaxation techniques, warm foot baths, and a combination of these two may be helpful in improving the sleep quality of patients. Therefore, this study was conducted to determine the effect of the combination of Benson relaxation and warm foot baths on the sleep quality of patients with acute coronary syndrome. Materials & Methods: This randomized controlled clinical trial was conducted in the winter of 2018 and spring of 2019 on 64 patients with acute coronary syndrome hospitalized in the ICU of Shahid Rajaee Hospital, Gachsaran, Iran. The patients were randomly allocated into four groups: Benson relaxation (16 patients), warm foot bath (16 patients), a combination of relaxation and foot bath (16 patients), and a control group (16 patients). Each intervention group received the intervention once every night (nights 2, 3, and 4) before bedtime in the hospital. The patients’ sleep quality was assessed by completing the St. Mary’s Hospital Sleep Questionnaire (SMHSQ) before (day 1) and after the intervention (in the morning of days 3, 4, and 5). The data were analyzed using SPSS 16 software, employing the chi-square, Kruskal-Wallis, and Bonferroni post hoc statistical tests. Findings: Sixty-four patients, including 40 males (62.5%) and 24 females (37.5%), with a mean age of 54.24±8.16 years, participated in this study. On night 4, a statistically significant difference was observed in each of the intervention groups, including warm foot bath (P=0.004), Benson relaxation (p=0.001), and the combination group (p=0.007), compared to the control group. However, no significant difference was indicated between the combination group and any of the individual intervention groups (p>0.05). Conclusion: Benson relaxation techniques, warm foot baths, and their combination equally improve sleep quality in patients with acute coronary syndrome. Relaxation Sleep Quality Foot Baths Acute Coronary Syndrome 2024 10 01 225 231 http://jccs.yums.ac.ir/article-1-226-en.pdf 10.58209/jccs.5.4.225

23-302 2026-08-08 10.1002

Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2024 5 4 N. Zareifrar A. Sharifi S.A. Khosravani M. Zoladl S.S. Khoramrooz K. Sharifi Aims: The ability of Staphylococcus aureus for biofilm formation caused increased bacterial viability in the host environment and antibiotic resistance. The antibacterial effects of plants such as Cydonia oblonga and Hypericum perforatum were known; However synergic effect of them compared to clindamycin was not found in the previous studies. Therefore, the aim of this study was to compare the antibacterial activity of hydroalcoholic extracts of Cydonia oblonga, Hypericum perforatum and synergistic effect of them against clinical isolates of biofilm formation with Clindamycin. Materials & Methods: In this descriptive and analytical study, 148 clinical strains were collected. Phenotypic analysis was performed by concord plate agar method and genotypic checking by PCR genes was performed simultaneously. MIC was obtained by microbroth dilution method. Data were analyzed by SPSS software version 21 and descriptive. Findings: From 148 clinical isolates of Staphylococcus aureus, 95 isolates (64.2%) of Staphylococcus aureus forming biofilm were isolated by Congord Agar phenotypic method which 12 isolates had genes during PCR.icaA.icaD clfA and fnbA. There was a significant difference between groups in MIC, MBC, and ZOI (p=0.0001). However, Clindamycin and Hypericum perforatum hydroalcoholic extract had lower MIC, and MBC against S. aureus biofilm, respectively compared to other interventions. Conclusion: The hydroalcoholic extract of Hypericum perforatum can be prescribed as a complementary medicine in the treatment of S. aureus biofilm, along with clindamycin. Staphylococcus Aureus Biofilm Cydonia oblonga Hypericum Perforatum 2024 10 01 233 239 http://jccs.yums.ac.ir/article-1-302-en.pdf 10.58209/jccs.5.4.233