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This research is a descriptive study. The purpose of conducting this survey was to estimate the prevalence of dental carvies by calculating the mean of Decay- Missing • Filling Teeth (D. M. F.) and (d.mf.) indices for about and children in the province ofzanjan in 1990.Independent variable was age and dependent were Decayed - Missed and Filled teeth.The total population of 300 were studied and chosen as sample size and consist/69 females and 131 males of those 200 people were chosen from urban (Zanjan) and 100 from rural (Dizeg-Abad).The results of this study shows thefolowing indications.1. At age 5-6 years old 100% were carries free in permanent teeth. While at age / 2 only 5% in urban and 6.5% in rural were carvies free.2. The mean of D.M.F at age 12, 15 and 35-44 were seen between urban and rural but it was significant by applied T.Test.Besides D.M.F. the investigator also tried togather some deta in some aspects of "knowledge", "Attitude" and "Practice", (KA.P) in regards of population oral health, by using multiple questionnaire.The analysis of deta indicates the following findings*3. Around 40% of the arban population who wereinterviewed indicated that they brush theirteeth daily (once a day), 50% after each and 7% occasionally.And around 28% of rural popution answered that they had the habit for daily beashing, and 20% after each meal and 46% occasion' ally.The X2 test were performed between these two categorize and the result was highly significant.

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  Background & Aim: The &beta-Thalassemia major is a chronic disease that needs a regular blood transfusion. The blood transfusion is a complex process with high probability of human errors during the process which results in serious adverse events in patients. Nurses should deliver care based on the best available evidence or best practice. The aim of this study was to develop an evidence-based clinical guideline of blood transfusion in children with thalassemia .

  Methods & Materials: This study was conducted during 16 months from 2013 to 2014 based on three-step process of guideline adaptation including set up, adaptation and finalization. During these steps, topic and aims of the study were clearly identified. Then health questions were designed based on the PIPOH method. After conducting systematic searches, quality of the retrieved clinical guidelines was evaluated using the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument and a committee consisting of experts and policy-makers in nursing field. After external review, expert panel meetings and consensus between members, the final version of the guideline was developed . 

  Results: The criteria of clinical practice regarding stages of blood transfusion were determined based on the evidence, cultural and health conditions and were presented in twelve sections.

  Conclusion: This clinical practice guideline developed based on evidence can guide blood transfusion process in clinical practice.

  

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  Background & Aim: Nurses’ hands are important channels of micro-organisms transmission and hospital acquired infections. This study aimed to investigate knowledge, beliefs and practices of nurses regarding hand hygiene .

  Methods & Materials: This was a cross-sectional study conducted in 2012. All nurses (n=282) working in three hospitals of Lorestan University of Medical Sciences participated in the study. Data were gathered using a demographic form, social desirability questionnaire, and hand hygiene knowledge, belief and practice questionnaire. Data were analyzed through descriptive and statistical tests (Independent t-test, ANOVA, Pearson Coefficient) in the SPSS-PC (v.21.0). The level of significance was set at below 0.05 . 

  Results: The mean scores of nurses’ hand hygiene knowledge, beliefs and practices were 4.6±2.00, 3.8±0.40, and 4.33±0.50, respectively. Nurses washed their hands after contact with patients more often in compare with prior to contact with patient. There was a statistically positive and significant correlation between nurses’ practice in required situations and nurses’ beliefs regarding hand hygiene .

  Conclusion: According to the results, nurses’ knowledge regarding hand hygiene was low and hand hygiene practice in required situations was undesirable. Many nurses had negative and false beliefs regarding hand hygiene. Based on these results, it is necessary to plan programs to increase nurses’ knowledge, belief and practice regarding hand hygiene .

  

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Background & Aim: Evidence-based practice (EBP) education is essential in nursing education. Therefore, identifying factors influencing nurses' adoption of EBP is very important to perform optimum quality nursing interventions. The aim of present study was to determine the factors affecting the adoption of EBP based on Rogers' diffusion of innovations models in nurses.

Methods & Materials: This was a descriptive–analytical study. The research subjects were 130 nurses who worked in the hospitals affiliated to Tehran University of Medical Sciences in 2014. The research instruments were four questionnaires including demographic data; knowledge, attitude and the adoption of EBP; individual innovation and perceived attributes of EBP. Data were analyzed by descriptive and inferential statistics (Pearson correlation coefficient and path analysis) on SPSS v.19 and EQS.

Results: The study findings showed that age and the working experiences of nurses had significant inverse relationships with knowledge of EBP (r=-0.809, r=-0.805). There was a direct relationship between individual innovation and knowledge (r=0.776). In addition, knowledge not only had a significant direct relationship with the adoption of EBP but also had the greatest impact on the adoption of EBP compared to other variables of model (r=0.937). Perceived attributes of EBP had significant direct relationships with attitude and the adoption of EBP (r=0.898, r=0.888 respectively). Attitude toward EBP also had a direct and significant relationship with the adoption of EBP (r=0.869). The results of the path analysis indicated the model variables to have an optimal fit (P<0.001).

Conclusion: The results of this study identify the factors affecting the adoption of EBP. Determining these factors can be an effective step to more adopt it in clinical environments.

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World’s health systems have entered a critical period of human resource shortage. The shortage of qualified nurses has been suggested as one of the most important barriers to achieve effective healthcare systems (1). According to the WHO (2014), there is currently a shortage of 7.2 million health care providers at the international level. This shortage is estimated to reach 12.9 million by 2035 (2). In other words, in order to develop healthcare systems, achieve positive outcomes and ensure patient’s safety, recruiting well-qualified nurses is a global concern (3). Nursing shortage in Iran has also become a concern for managers and a major challenge to the healthcare system. The nursing deputy of the Iran Ministry of Health and Medical Education reported that the number of nurses working in health care settings is estimated to be 140,000, but there is a need for 2,60,000 nurses to deliver ideal levels of health care (4). While, qualified nurses adequacy is one of the essential components of the nursing professional practice environment (5). Poor nursing work environment, inadequate resources, imbalanced workload, disproportionate nurse-patient ratio, high bureaucracy (5), lack of supportive management, low salaries, and reduction in employment are major challenges that have caused Iran’s healthcare system to face a serious crisis of nursing shortage despite a large number of young nursing graduates (6). Evidence suggests that the nursing practice environment has a significant role in the retention of expert nurses, the quality of care and, safety of patients (7). Poor nursing work environments are related to adverse patient outcomes, including an increase in mortality rate, patient falls, and medication errors (8, 9). In addition, unhealthy workplaces are important causes of turnover, efficient nurses’ intention to leave, early retirement, job dissatisfaction and burnout (10, 11). Therefore, efforts to create environments that attract and retain nurses are worthwhile. Different strategies have been proposed to improve the nurses’ work environment. In this regard, making workplace attractive is a basis for increasing the quality of nursing practice environment (12).
Today, there are hospitals called "Magnet Hospital" that are renowned for attracting and retaining expert nurses. The Magnet hospital was first used in the United States. In the early 1980s, concurrent with nursing shortage crisis in the United States, extensive studies were begun to examine the organizational structures of Magnet hospitals. In a study, the American Academy of Nursing (AAN) identified 41 hospitals that were known to attract and retain qualified nurses, and used the term "Magnet" as a gold standard for nursing practice in these hospitals (13). Magnet hospitals are evaluated in terms of achieving goals in five areas including transformational leadership, structural empowerment, new knowledge, innovation, and empirical outcomes and development (14). Magnet hospitals with a more different organizational structure than non-Magnet ones play an important role in nurses’ job satisfaction and retention (15). One of the main reasons for the attractiveness of these hospitals is the existence of work environments focusing on decentralized decision-making, autonomy, control over practice, resource adequacy, supportive management, effective inter-professional communication, and career development (16). In other words, the organizational attributes of Magnet hospitals lead to the nurses’ empowerment by increasing autonomy and authority, and subsequently improving job satisfaction. These hospitals have designed a set of work environment standards to support professional nursing practice (17). Many studies have shown that Magnet hospitals provide a healthier environment with higher job satisfaction for nurses and better outcomes for patients, compared to non-Magnet ones (18, 19). In recent years, the development of Magnet hospitals has rapidly grown in various countries. Considering the complexity of nursing shortage phenomenon, paying attention to the factors influencing the nurses’ attraction, retention and productivity is important to overcome the challenge of nursing shortage (20).
Conclusion
The nurses’ dissatisfaction with the work environment and consequently, the shortage of competent and educated nurses, is a major challenge to Iran’s health system. Therefore, solving this crisis is vital to prevent adverse health consequences. In this regard, nursing managers and health policy-makers can create a quality work environment using the features of Magnet hospitals to increase the attraction and retention of health care professionals, especially nurses. This will not only result in the nurses’ job satisfaction but will also increase the quality of care and ensure the patients’ safety.