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IRCT20240212060983N1 IRCT 2024-05-23 Tehran University of Medical Sciences Investigating the effect of multiple nursing interventions on ischemic stroke-related pneumonia SAP The Effect of Multiple Nursing Interventions on the Incidence of Stroke Associated Pneumonia in Patients 2024-05-21 anticipated 64 Complete https://irct.ir/trial/76536 interventional Randomization: Randomized, Blinding: Not blinded, Placebo: Not used, Assignment: Other, Purpose: Prevention, Randomization description: In this study, patients are divided into two control and intervention groups based on the random assignment of quadruple blocks; Regarding the equal placement of the samples in the two control and intervention groups, a limited randomization method called blocking was used. This method helps this study so that in cases where intermediate analyzes are needed during the sampling process, the number of samples allocated to each of the studied groups is equal. In this study, the size of all blocks is equal. In this study, online randomization was used to generate random sequences. The decision to accept or reject participation in the study is made first and the informed consent form is completed, and then the participants are randomly assigned to each group. N/A Ischemic stroke. Intervention 1: In order to collect the necessary data for the study, three tools and a checklist will be used; With the help of these tools and checklist, patients' conditions are accurately evaluated and then based on the results, appropriate nursing care is provided for each patient's condition. Tool number one (GUSS) consists of two tests; The test starts with swallowing saliva and then continues with swallowing semi-solid, liquid and solid tissues respectively. Instrument number two (IDDSI) consists of two components: food and beverage component; The nutritional strategy will be chosen by the nurse based on the severity of dysphagia, for example, in moderate dysphagia, feeding will be through a nasogastric tube and the use of pureed food, and in severe dysphagia, the patient will be given fasting and supplements through a nasogastric tube. will be. Oral care will be done using a ten-step checklist. In this study, nursing interventions to affect the occurrence of pneumonia related to ischemic stroke will include the examination of the severity of dysphagia, strategies related to diet and oral care methods in this group of patients after a detailed evaluation of the parameters of the tools and the above checklist. After the implementation of the mentioned care package, in this study, in order to evaluate stroke-related pneumonia, the developed symptoms include the presence or absence of fever, cough and white blood cells equal to and greater than 10x109 per liter or white blood cells equal to and smaller than 4 x 109 per liter and the final diagnosis of the neurologist will be examined by the stroke-related pneumonia tool and finally the occurrence of SAP will be announced by him. Intervention 2: Control group: will receive routine ward care for four consecutive days. Undecided - It is not yet known if there will be a plan to make this available Justification or reason for indecision in sharing IPD is There is no further information.
public Asma Rostami
No. 4, Mazari 19, Mazari Mazari Boulevard
Zahedan Iran (Islamic Republic of) 9817747843 +98 54 3344 0566 nrsasma1155@gmail.com Tehran University of Medical Sciences scientific Maryam Esmaeili
Dr. Mirkhani Ave. (East Nosrat), Tohid Square
Tehran Iran (Islamic Republic of) 1419733171 +98 21 6692 7171 mesmaeilie77@gmail.com Tehran University of Medical Sciences Iran (Islamic Republic of) Detecting confirmation of ischemic stroke by a specialist physician Moderate or intense dysphagia (in accordance with the GUSS tool score 0-14) Age older than 18 24 hours after the onset of ischemic stroke symptoms NIHSS score above 3 Direct acceptance of the patient from the emergency department or the patient's direct referral to the doctor's office and then referred to the department 18 years no limit Both Presence of pneumonia before hospitalization Patients with liver and kidney failure Infectious patients Patients in need of specialized oral care and evaluation Allergy to chlorhexidine Oral surgery Gum diseases Infectious diseases of the mouth Patients with immunosuppression Having any malignancy Lack of consent to participate in the study Prevention Prevention In order to collect the necessary data for the study, three tools and a checklist will be used; With the help of these tools and checklist, patients' conditions are accurately evaluated and then based on the results, appropriate nursing care is provided for each patient's condition. Tool number one (GUSS) consists of two tests; The test starts with swallowing saliva and then continues with swallowing semi-solid, liquid and solid tissues respectively. Instrument number two (IDDSI) consists of two components: food and beverage component; The nutritional strategy will be chosen by the nurse based on the severity of dysphagia, for example, in moderate dysphagia, feeding will be through a nasogastric tube and the use of pureed food, and in severe dysphagia, the patient will be given fasting and supplements through a nasogastric tube. will be. Oral care will be done using a ten-step checklist. In this study, nursing interventions to affect the occurrence of pneumonia related to ischemic stroke will include the examination of the severity of dysphagia, strategies related to diet and oral care methods in this group of patients after a detailed evaluation of the parameters of the tools and the above checklist. After the implementation of the mentioned care package, in this study, in order to evaluate stroke-related pneumonia, the developed symptoms include the presence or absence of fever, cough and white blood cells equal to and greater than 10x109 per liter or white blood cells equal to and smaller than 4 x 109 per liter and the final diagnosis of the neurologist will be examined by the stroke-related pneumonia tool and finally the occurrence of SAP will be announced by him. Control group: will receive routine ward care for four consecutive days. Stroke-related pneumonia. Timepoint: Before the implementation of the intervention and then 4 days after the end of the intervention. Method of measurement: Ischemic stroke-related pneumonia instrument. Tehran University of Medical Sciences Approved 2024-01-30 Joint Organizational Ethics Committee of Nursing and Midwifery Faculty and Rehabilitation Faculty of No.4, Mazari 19, Mazari Boulevard Zahedan Sistan-va-Balouchestan Iran (Islamic Republic of)