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  Background & Aim: Access to quality care is important in delivering health services. Patients' safety and satisfaction are indicators of quality of care evaluation. Competent nurses may deliver quality care . This study aimed to investigate the impact of using competent nurses on patients’ safety and satisfaction .

  Methods & Materials: In t his interventional study with non-equivalent control group, we selected 120 patients admitted to the emergency department of Imam Khomeini hospital in 2012 using convenience sampling method . Nursing care for the experimental group (n=40 ) was provided by nurses who had high competency scores and in the control group ( n=80), nursing care was provided by usual emergency department nurses . Data were collected using the patient satisfaction with nursing care quality (PSNCQ), and patient safety inventory. Data were analyzed in the SPSS v.16 using descriptive and inferential statistics . The significance level for all statistical tests was considered at P<0.05 .

  Results: Mean age of the intervention and control groups were 48.1 ( ±12.5) and 40.5 ( ±16.7), respectively (P<0.018). There was a significant difference between the two groups in terms of employment (P<0.009). The two groups were similar in terms of other variables such as gender, marital status, level of education, having health insurance , and the reasons for seeking admission . The results showed that there were significant differences between the two groups in patients’ safety and satisfaction with nursing care (P<0.001). Regression test was used to eliminate the effects of age and job satisfaction the results showed effect of intervention on the patients’ safety and satisfaction with nursing care .

  Conclusion: These findings indicated that using competent nurses in providing nursing care promotes patients’ safety and satisfaction with nursing care. Training nurses focusing on the level of competency is required in scheduling, staffing, and implementing nursing care to enhance safety, patient satisfaction , and quality of care.

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  Background & Aim: Governing organizational culture in hospitals can affect patients’ safety through establishment of behavioral norms among nurses. This study aimed to determine the relationship between nurses’ perception of organizational culture and their performance about patients’ safety .

  Methods & Materials: In this cross sectional, descriptive-correlation study, we used stratified sampling method to recruit 250 nurses working in general wards and emergency departments of general hospitals in Babol, 2013. Data were collected through questionnaires and were analyzed using the descriptive and inferential statistic tests including the Pearson test, ANOVA test and T-test in the SPSS . 

  Results: Nurses' perception of organizational culture was "fairly desirable" (54.5%). Performance of the nurses in the field of patients' safety was "desirable" (88%). The Pearson test showed that there was a positive and statistically significant correlation between nurses’ perception of organizational culture and their performance in the field of patients’ safety (P<0.01) .

  Conclusion: It seems that improving organizational culture in hospitals can enhance nurses’ performance in the field of patients' safety .

  

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Background & Aim: Patient falling is one of the most important indicator of patient safety. Nurses have an important role in the prevention of patient falls and the improvement of patient safety standards. The current study aimed to determine the relationship between the incidence of patient falls and nurses’ professional commitment.

Methods & Materials: In this cross-sectional study,300 nurses employed in hospitals affiliated to Tehran University of Medical Sciences, were selected through a proportional stratified sampling method. Data were collected by a three-part questionnaire consisted of the demographic data, the Nurses’ Professional Commitment Scale and the reports on the number of patient falls in the past three months. Data were analyzed on SPSS software using statistical tests including Pearson's correlation coefficient, Kruskal-wallis and independent-t test.

Results: The mean score of patient falls in the past 3 months was 6±1.61(moderate) for each nurse and the mean score of nurses' professional commitment was 86±8.61 (committed).A significant and reverse relationship was observed between the incidence of patient falls and nurses’ professional commitment (R= -0.51; p<0.018).There is no relationship between nurses’ demographic characteristics and patient falls.

Conclusion: Despite the lower incidence of falls in the patient under the supervision of the committed nurses, its prevention entails taking into account all factors that influence this phenomenon besides improving professional commitment.

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Background & Aim: Error always occurs in the health system and it can lead to irreparable consequences. Therefore, error prevention must be taken into account by the health systems. Detection of factors contributing to error is a key factor for the prevention of error. Hence, the aim of this study was to explore factors contributing to nursing error in emergency department.

Methods & Materials: This study was conducted using a qualitative approach. 17 emergency nurses participated in this study. Semi-structured interview was used to collect the data. Sampling was started as the purposive sampling and continued until the saturation of data was reached. Data were analyzed using the Elo & Kyngas (2008) qualitative content analysis approach. To achieve trustworthiness, participants were selected with maximum variation in terms of age, gender, work experience, and educational background.

Results: The analysis of data led to the emergence of 500 open codes and four categories including the predisposing factors of nurse-related error, predisposing factors of organization-related error, predisposing factors of error related to the culture of emergency department and predisposing factors of patient-related error.

Conclusion: Factors contributing to nursing errors in emergency department were very wide and multifactorial. Identifying the factors contributing to error is a first step to prevent errors. For reducing nursing error, nursing managers should pay special attention to the contributing factors of error identified by this study and implement interventions to reduce and mitigate these factors.

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Background & Aim: The success of the surgical safety checklist in reducing surgical mortality and morbidity largely depends on the degree of compliance with the checklist and correct implementation of its components by the staff. The aim of this review is to determine the challenges of effective implementation of the surgical safety checklist and to provide solutions for its more effective implementation.
Methods & Materials: In the present systematic review, all the relevant qualitative papers published from 2010 to October 2018, were examined. A  literature search was done in databases SID, Iran Medex, Iran doc, Magiran, Science Direct, Medline/PubMed, Web of Science, Scopus, ProQuest, Google Scholar, Cochran Library with keywords patient safety, surgical procedures, operative, checklist, World Health Organization, implementation science, qualitative research and their equivalent terms in Persian. Inclusion criteria were articles written in English or Persian, qualitative studies and relevant to the objectives of the study. Exclusion criteria were review articles, posters, presentations, letters to editor and quantitative studies.
Results: The findings of the review of 14 qualitative studies showed that the most important challenges in effective implementation of the surgical safety checklist were unpredictable priorities, lack of collaboration and coordination of the surgical team members, mismatch between the checklist and hospital setting, lack of patient’s cooperation and lack of a planned approach towards implementing the checklist. The strategies to improve the implementation of the surgical safety checklist included checklist localization, improving the collaboration and coordination of all the team members, training and practicing, patient participation, and active organizational leadership.
Conclusion: The introduction of the surgical safety checklist to the health care setting is a permanent challenge and requires ongoing evaluations and its integration into the workflow in the hospital, active and effective leadership, explanation of why and how to use it by managers and receiving support from the organization. Continuous education, performance evaluation and the participation of all the surgical team members in the implementation of the checklist are key factors for effective implementation of the surgical safety checklist.