Mostafa Ghanei; Seyed Hassan Saadat; Alireza Najimi-Varzaneh; Mohammad Gholami Fesharaki
Volume 26, Issue 1 , 2024
Abstract
Context: The prevalence of in-hospital death due to COVID-19 hospital is one of the qualitative indexes, which can be used to assess the quality of care, as well as the mortality patterns in COVID-19 pandemic.Objectives: Therefore, this study has been done with the goal of estimating overall prevalence ...
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Context: The prevalence of in-hospital death due to COVID-19 hospital is one of the qualitative indexes, which can be used to assess the quality of care, as well as the mortality patterns in COVID-19 pandemic.Objectives: Therefore, this study has been done with the goal of estimating overall prevalence in-hospital death due to COVID-19 disease in iranian patients.Evidence Acquisition: Articles were identified through iranian searching databases including Health.barakatkns, IranDoc, SID, Civilica and MagIran and international searching databases including Scopus, Web of Science, PubMed and Elsevier . Additional search was also done by Google Scholar search engine. We reviewed systematically all studies reporting the prevalence of in-hospital death due to COVID-19 disease. In this study meta-analysis method with random effect model has been used to estimate the pooled in-hospital death.Results: 118 records were identified by the electronic search, of which 43 studies were identified as relevant documents that were meta-analyzed for the pooled in-hospital death due to COVID-19 prevalence. Overall, prevalence of death were 12.16% (95% CI: 10.72%-13.61%). The highest and lowest death prevalence has been reported in Northern Provinces (Gilan, 27.27% (95% CI: 8.66%-45.88%) and Mazandaran, 21.27% (95% CI: 18.14%-24.40%)) and Turkish-speaking provinces (Azerbaijan, East, 3.29% (95% CI: 2.11%-4.47%) and Zanjan, 3.42% (95% CI: 1.82%-5.02%)) respectively.Conclusions: Considering the death rate obtained in this study and its comparison with other countries, it can be said that the performance of the Iranian medical system in COVID-19 pandemic is acceptable.
Aysel Kokcu Dogan
Volume 25, Issue 12 , 2023
Abstract
Background: Non-adherence to hygiene rules by the parents who accompany their hospitalized children increases the likelihood of their children contracting COVID-19 and may consequently cause fear in parents.
Objective: The present study aimed to determine the effect of COVID-19-induced fear on the hygiene ...
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Background: Non-adherence to hygiene rules by the parents who accompany their hospitalized children increases the likelihood of their children contracting COVID-19 and may consequently cause fear in parents.
Objective: The present study aimed to determine the effect of COVID-19-induced fear on the hygiene behavior of parents with hospitalized children.
Method: This study was conducted based on a descriptive design between November 2021 and March 2022. The participants consisted of 233 parents accompanying their children to the pediatric department of a hospital. Data were collected by the face-to-face interview technique using the "Demographic Information Form", "COVID-19 Hygiene Scale", and "Fear of COVID-19 Scale". The data were analyzed in SPSS software. During the frequency analysis of continuous and categorical data, comparisons between variables and scales were tested for their conformity to normality distributions.
Results: Based on the results, 96.6% of parents were female and 36.1% were university graduates. Parents' mean scores of COVID-19-induced fear and hygiene behavior were obtained at 18.4 and 100.2, respectively. COVID-19-induced fear affected hygiene behavior (P<0.05).
Conclusion: As evidenced by the results of this study, COVID-19-induced fear of parents with hospitalized children increased their hygiene behavior. Therefore, raising public health awareness for COVID-19 and providing outbreak preparedness training by hospital health professionals for parents with hospitalized children will be paramount for preventing infectious diseases.
Roohollah Askari; Nahid Hosseini Dargani; Najmeh Baghian; Hojjat Ghaffari; Zahra Rezaeian; Ommol-Banin Sarkari; Majid Hajimaghsoudi; Adel Eftekhari
Volume 25, Issue 6 , 2023
Abstract
Background: The COVID-19 pandemic created an unprecedented challenge for intensive care units (ICUs) compared to other clinical wards. In addition, it caused stressful conditions due to the increased mortality rates in these wards.
Objectives: Since the identification of these challenges can serve as ...
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Background: The COVID-19 pandemic created an unprecedented challenge for intensive care units (ICUs) compared to other clinical wards. In addition, it caused stressful conditions due to the increased mortality rates in these wards.
Objectives: Since the identification of these challenges can serve as a road map for managers in future planning against crises, the present study aimed to identify the challenges of ICU caregiving during the COVID-19 pandemic.
Methods: This qualitative study used conventional content analysis and was conducted using unstructured deep interviews with an open question and several co-constructive questions in 2023. A total of 23 ward heads, head nurses, nurses of ICU wards, nursing managers, and supervisors of six teaching hospitals affiliated with Isfahan University of Medical Sciences and Yazd Universities of Medical Sciences were included in the study through a purposive sampling method. Data analysis was performed with MAXQDA10 using qualitative content analysis with a conventional approach.
Results: The challenges of ICUs in the COVID-19 pandemic were identified and categorized into six main categories and 14 sub-categories. The main categories included: inefficient management of resources, weaknesses in organization, challenges to laws and regulations/policies, structural challenges, weaknesses in educational processes, and mental challenges.
Conclusion: The findings of this study showed that it is possible to provide quality services to patients by identifying the challenges affecting the management and provision of nursing services and taking appropriate measures to improve the quality of nursing services in the intended wards.
Somayeh Fazaeli; Mehdi Yousefi; Mohadeseh Sabethoseini Dokht
Volume 23, Issue 12 , 2021
Abstract
Background: The ongoing coronavirus disease 2019 (COVID-19) pandemic increased the need for inpatient beds, indicating the need for hospitals to increase the efficiency of beds.
Objectives: This study aimed to increase hospital bed capacity using the implementation of Electronic Patient Discharge (EPD).
Methods: ...
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Background: The ongoing coronavirus disease 2019 (COVID-19) pandemic increased the need for inpatient beds, indicating the need for hospitals to increase the efficiency of beds.
Objectives: This study aimed to increase hospital bed capacity using the implementation of Electronic Patient Discharge (EPD).
Methods: This qualitative-quantitative study was conducted in a tertiary care hospital using the pre-and post-intervention designs, and the main outcome was patient discharge time. By applying the Six Sigma model, including definition, measurement, analysis, improvement, and control, the patient discharge process was assessed and improved by some interventions such as EPD. All hospitalized patients with COVID-19 from 21 March 2020 to 22 July 2021 were examined for the post-intervention. In addition, data were collected from the hospital information system.
Results: By the use of EPD, patient discharge time decreased to 47.70% (from 10.19 h to 5.33 h) (P?<?0.000). According to the Sigma level, the yield and defects per million opportunities of the discharge process also increased to 55%.
Conclusion: Six Sigma methodology can be an effective change management tool to improve discharge time to cover the demand created during pandemics. According to the results of the present study and the obtained saved time, one bed is added to the hospital capacity for every five discharges.
Seyed Payam Paymard; Leila Najafi; Esrafil Roshdi
Volume 23, Issue 7 , 2021
Abstract
Background: Performance evaluation of accreditation schemes can improve the quality of hospital accreditation significantly. An effective accreditation system is one that performs the accreditation process properly and achieves acceptable results.
Objectives: This study aimed to design and validate the ...
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Background: Performance evaluation of accreditation schemes can improve the quality of hospital accreditation significantly. An effective accreditation system is one that performs the accreditation process properly and achieves acceptable results.
Objectives: This study aimed to design and validate the performance evaluation model of national accreditation schemes in hospitals.
Methods: This study was performed in a mixed method. The performance evaluation dimensions of the national accreditation models for hospitals were identified, classified, and modeled using the qualitative research method. The quantitative aspect of the obtained model was tested using structural equation modeling.
Results: All identified variables were classified into six dimensions including causal conditions, strategic conditions, axial phenomenon, context conditions, intermediary/interventional conditions, and consequence. The results of the quantitative part suggested that the proposed model had a good fit and its validity and reliability were confirmed.
Conclusion: The results of the present study revealed that the performance evaluation model of national accreditation schemes in hospitals had a good fit and might be used as an effective model in accreditation organizations as a roadmap to better evaluate accreditation schemes, such as those used in hospitals.
Somayeh Fazaeli; Mehdi Yousefi; Jamshid Jamali; Zahra Ebrahimi; maliheh hemati esmaeili
Volume 23, Issue 5 , 2021
Abstract
Background: Nursing care activities in the context of infectious epidemics, such as COVID-19, can lead to high levels of stress in nurses.
Objectives: This study aimed to investigate the relationship between the occupational stress and adequacy of hospital support measures among nurses with the experience ...
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Background: Nursing care activities in the context of infectious epidemics, such as COVID-19, can lead to high levels of stress in nurses.
Objectives: This study aimed to investigate the relationship between the occupational stress and adequacy of hospital support measures among nurses with the experience of caring for patients with infectious and non-infectious diseases during the COVID-19 outbreak.
Methods: This descriptive-analytical and cross-sectional study was conducted on nurses caring for patients with COVID-19 in Imam Reza Hospital Complex in Mashhad, Iran. The sample size was determined at 194 nurses who were selected through random sampling. The data were collected using a standard questionnaire and analyzed through a structural equation modeling approach using Smart PLS software (version 2.0). Moreover, descriptive and inferential statistics were employed for data analysis.
Results: The results of the correlation analysis showed a negative and significant relationship between occupational stress and adequacy of hospital support measures (P<0.001). Furthermore, the mean occupational stress scores of the nurses with the experience of working in infectious and non-infectious diseases wards were 63.96 and 65.34, respectively. Additionally, there was no difference between the mean values of occupational stress of nurses with the experience of working in non-infectious and infectious diseases wards. Moreover, the effects of the control variables of the work shift (morning, evening, or night) and work experience (years) were not significant in this study.
Conclusion: The COVID-19 epidemic caused many nurses to work in new and sometimes stressful environments and conditions. Proper work shifts, improvement of interpersonal communication, and provision of ongoing supportive measures can be effective in reducing occupational stress.
Ghasem Bahramiazar; MohammadHossein Chalak; Javad Rasaee; Mahdieh Rastimehr; Reza Fahimi; Fatemeh Ramroudi Nasab; Hossein Jafari
Volume 23, Issue 2 , 2021
Abstract
Background: Identification of the factors contributing to the errors of medical staff and examining the causal relationships among those factors can help better manage and design more effective policies and practices.
Objectives: This study aimed to identify the causes and factors affecting medical ...
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Background: Identification of the factors contributing to the errors of medical staff and examining the causal relationships among those factors can help better manage and design more effective policies and practices.
Objectives: This study aimed to identify the causes and factors affecting medical error management and determine a model for better management of such errors.
Methods: This descriptive-analytical study was conducted in two qualitative and quantitative phases. In the quantitative part of the study, the factors related to medical error management were identified and validated through reviewing previous studies and interviewing some specialists. Following that, the fuzzy decision-making trial and evaluation method was used for structural modeling of the factors and investigating the causal relationships among them in the quantitative part.
Results: In this study, the results showed that the "education and learning from error" subfactor had the most significant impact on the system. The second highly effective subfactors in the management of medical errors were "organizational communication and improved information access", "safety culture and climate", and "policies, procedures, and guidelines". In addition, the "safety culture and climate" was the most important factor that had the most critical impact on the system. Moreover, the "handoff conversations and communication" subfactor was mostly influenced by the other factors, followed by the "incident reporting system", "error prevention and corrective measures", "safety culture and climate", and "individuals' participation".
Conclusion: According to the results of this study, the health care industry should take into consideration both organizational and individual factors in error management. In order to achieve better planning and higher performance in error management, increase patient safety, and ultimately improve the quality of hospital services, it is suggested to consider the causes and factors affecting the system.
Milad Ahmadi Marzaleh; Rita Rezaee; Abbas Rezaianzadeh; Mahnaz Rakhshan; Gholamhassan Haddadi; Mahmoudreza Peyravi
Volume 21, Issue 5 , 2019, Pages 1-8
Abstract
Background: The emergency department is the entrance gate of patients to a hospital. Hospitals are confronted with major chal- lenges in radiation, nuclear accidents, and nuclear terrorism. Iran is also at risk of disasters, accidents, and threats, so, the possibility of nuclear and radiation accidents ...
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Background: The emergency department is the entrance gate of patients to a hospital. Hospitals are confronted with major chal- lenges in radiation, nuclear accidents, and nuclear terrorism. Iran is also at risk of disasters, accidents, and threats, so, the possibility of nuclear and radiation accidents cannot be neglected.Objectives: The present study aimed to extract the effective factors in emergency department preparedness of hospitals for radia- tion, nuclear accidents, and nuclear terrorism in Iran.Methods: This qualitative study was conducted using in-depth semi-structured interviews with 32 key informants selected through purposive and snowball sampling. Experts were from seven different specialties. Data were analyzed using the thematic analysis method in order to extract the effective factors in emergency department preparedness of hospitals for radiation, nuclear accidents, and nuclear terrorism in Iran in 2019. The interviews were held in the cities of Bushehr, Tehran, Shiraz, and Isfahan from September 2018 to February 2019.Results: Effective factors in emergency department preparedness of hospitals were categorized into staff preparedness, equipment preparedness, and system preparedness with 20 subcategories. The experts emphasized that training courses and exercises could enhance the preparedness and response to these accidents.Conclusions: This study showed that the emergency departments of hospitals in Iran have many challenges. When the country moves towards having nuclear technology, must also provide the infrastructure of the preparedness. There must be an attempt toreduce these challenges by providing financial and structural support. Identifying effective factors in preparation can be helpful in setting up programs for emergency department preparedness of hospitals against nuclear and radiation accidents.
Alireza Ala; Farzad Rahmani; Sahar Shirzadegan; Haniyeh Ebrahimi Bakhtavar; Robab Mehdizadeh Esfanjani
Volume 20, Issue 4 , 2018, Pages 1-6
Abstract
Background: Epistaxis is the most common otolaryngologic emergency. Objectives: The current study aimed at evaluating the therapeutic effect of the Celox® bandage to manage non - traumatic epistaxis in the emergency department.Methods: In the current randomized, clinical trial, 150 patients with ...
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Background: Epistaxis is the most common otolaryngologic emergency. Objectives: The current study aimed at evaluating the therapeutic effect of the Celox® bandage to manage non - traumatic epistaxis in the emergency department.Methods: In the current randomized, clinical trial, 150 patients with non - traumatic epistaxis admitted to the emergency depart- ment in Imam Reza and Sina hospitals affiliated to Tabriz University of Medical Sciences, Tabriz, Iran, during years 2015-2016. The patients were randomly divided into two groups: group 1 dressing with the Celox® band and group 2 dressing with the anterior nasal tampon. The convenient sampling method was employed. Bleeding control (minute), patients’ satisfaction, and lack of rebleeding within the first 24 hours of administration were compared between the two groups. Results: There was no statistically significant difference between the two groups in terms of demographic variables, vital signs, and paraclinical testing results (P > 0.05). With respect to the control of bleeding in the first 5 minutes after management, 93.3% of the bleeding was controlled in the Celox®, and 96% of the bleeding was controlled in the anterior tampon groups (P = 0.467). The satisfaction level of the patients in the Celox® group was greater than that of the tampon group, and the difference was statis- tically significant (P < 0.001). Lack of rebleeding within 24 hours after management had the most significant effect on the patient satisfaction [odds ratio (OR) = 3.969]. Conclusions: Based on the results of the current study, there was no significant difference in bleeding control and the success ratebetween the two groups in the study. Ease of usage, however, makes Celox® a better alternative to control epistaxis. Furthermore, the treatment of epistaxis with Celox® leads to higher satisfaction levels.
Seyyed Majid Shirzadi; Amir Ashkan Nasiripour; Pouran Raeissi; Seyyed Jamaleddin Tabibi
Volume 19, Issue 9 , September 2017, , Pages 1-9
Abstract
Background: Based on the importance of quality of hospital hoteling services on health system outcomes and lack of a valid assessment method to determine and implement the required strategies to evaluate and improve the service quality, the current study aimed at determining factors affecting the quality ...
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Background: Based on the importance of quality of hospital hoteling services on health system outcomes and lack of a valid assessment method to determine and implement the required strategies to evaluate and improve the service quality, the current study aimed at determining factors affecting the quality of hoteling services in teaching hospitals affiliated to universities in Iran.Methods: The current cross sectional study was designed in 2 phases of qualitative and quantitative. In the 1st phase, factors affecting the quality of hospital hoteling services were extracted from the literature and through an in-depth interview with 11 experts (6 from healthcare administration and 5 from the Iranian hoteling industry organization).In the 2nd phase, the data from the 1st phase were integrated and a model for the improvement of the quality of hospital hoteling service was designed. The model was validated through a qualitative (expert opinion) and quantitative approaches (exploratory and confirmatory factor analysis). The data of the factor analysis were collected from 960 patients in 10 teaching hospitals from 10 different cities across the country.Results: The findings of the current study indicated that 11 factors (physical, functional, economical, human factor, social welfare services, clinical welfare services, safety, cultural, personnel identification, patient guide factors, and healthcare services) explained 65.81% of the variances in the quality of hoteling services. Based on the conformity factor analysis, functional and personnel identification factors with a coefficient of 0.953 and 0.779 had the highest and lowest weight to explain the variance of the quality of the hoteling services, respectively, in the teaching hospitals affiliated to different medical universities in Iran.Conclusions: Hoteling services quality model has a multidimensional construct and in the current study 11 important ones were identified, out of which functional and personnel identification factors had the highest and lowest weight in explaining the variance of the stated construct
Aygul Yanik; Meryem Ortlek
Volume 19, Issue 6 , June 2017, , Pages 1-7
Abstract
Background: Using time effectively has become increasingly important in terms of the successful performance of healthcare managers.Objectives: In this study, the time management behaviors of healthcare managers and the effects of demographic variables on these behaviors are determined.Methods: This ...
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Background: Using time effectively has become increasingly important in terms of the successful performance of healthcare managers.Objectives: In this study, the time management behaviors of healthcare managers and the effects of demographic variables on these behaviors are determined.Methods: This cross-sectional and descriptive research was carried out on managers from five hospitals in Tekirdag, Turkey. The data was collected with the survey method. The research population of 175 managers were targeted with an initial invitation to participate in the study. However, only 163 managers accepted the invitation to complete a questionnaire. SPSS for Windows 15.0 package software was used to analyze the data.Results: For managers, general planning, meeting management, determining priorities, substitution, table and file folder set up, procrastination, and answering unnecessary phone calls were found to occur frequently; general time management was also found to consume a significant amount of time, whereas saying “no” to visitors was determined to be of only an average level of time consumption. With respect to the scores of women, determining priorities, saying “no” to visitors, table and file folder set up, and procrastination took up more time than they did for men.Conclusions: It was determined that demographic variables do affect the time management behaviors of healthcare managers.
Mohammad Hossien Kaveh; Zakieh Khoramaki; Javad Kojouri; Sareh Keshavarzi
Volume 19, Issue 1 , January 2017, , Pages 1-7
Abstract
Background: The empowerment of heart failure (HF) patients to improve self-care behaviors through appropriate training programs is necessary. Evidence has indicated a lack of theory-based trials in hospitals and healthcare centers, both of which represent important health promotion settings.Objectives: ...
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Background: The empowerment of heart failure (HF) patients to improve self-care behaviors through appropriate training programs is necessary. Evidence has indicated a lack of theory-based trials in hospitals and healthcare centers, both of which represent important health promotion settings.Objectives: This study aimed to examine the effect of a hospital-based educational program based on the constructs of the health belief model (HBM) on self-care behaviors of patients with HF.Methods: This controlled quasi-experimental study consisted of 84 patients with HF (42 patients in an intervention group and 42 in a control group) who were admitted to two large, specialized, referral hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran from April to August 2015. The patients were selected using purposive sampling. Data on self-care according to the constructs of the HBM were collected using a European HF self-care behavior questionnaire and a researcher-made questionnaire.Results: Before the intervention, the mean score for self-care behaviors was 30.69 ± 5.13 in the intervention group and 31.23 ± 5.48 in the control group. In the first and second post-tests of the intervention group, the mean scores for self-care behaviors were 39.47 ± 3.40 and 40.09 ± 2.91, respectively (P < 0.001). There was a significant increase in the determinants of self-care behaviors based on the HBM after the intervention. The results also pointed to a significant difference in the constructs of the HBM (knowledge, perceived susceptibility, severity, benefits, barriers, cues to action and self-efficacy) in the intervention group during different stages of measurement.Conclusions: This study showed that implementation of the HBM-based educational intervention positively influenced the selfcare behaviors of patients with HF. Thus, implementing long-term educational interventions, including continuous follow-ups, in inpatient treatment centers may result in improved and sustained self-care behaviors. We strongly suggest that novel trials of educational interventions that use other health behavior theories and training strategies are needed to expand training knowledge in hospitals.
Mehdi Habibi; Mohammad Gholami Fesharaki; Hossein Samadinia; Maryam Mohamadian; Somayesadat Anvari
Volume 19, Issue 1 , January 2017, , Pages 1-5
Abstract
Background: Sufficient evidence is lacking about patient safety culture in Iran. It is only by focusing on the culture of safety within healthcare and treatment institutes that improvements may be made in patient care services.Objectives: The present study aimed to examine patient safety culture and ...
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Background: Sufficient evidence is lacking about patient safety culture in Iran. It is only by focusing on the culture of safety within healthcare and treatment institutes that improvements may be made in patient care services.Objectives: The present study aimed to examine patient safety culture and factors that affect that culture in two hospitals in Tehran city.Patients and Methods: A cross-sectional study was conducted in two government teaching hospitals (135- and 650-bed hospitals) in Tehran city in February of 2013 using a proportional stratified sampling method. The participants completed questionnaires with questions concerning their demographics and patient safety culture.Results: Overall, the study participants rated patient safety culture within their healthcare institutions at 64.7%. The highest and lowest patient safety culture subscales were 73.8% and 50.1% for “teamwork within units” and “staffing,” respectively. According to the findings, hospital size (P < 0.001) and hospital area (P < 0.001) had a significant relationship with patient safety culture.Conclusions: Given that “Staffing” was the lowest rated element in patient safety culture, improving this element could help to increase patient safety culture in hospitals in Tehran.
