Hospital

Relationship between Mental Health Dimensions with Organizational Commitment and Work Ethics of Nurses Working in General Hospitals Affiliated to Tehran University of Medical Sciences

sajjad alahdadi

Background: Human resources form the basis of health care systems and nurses are a large part of this community; therefore, paying attention to factors affecting the performance of nurses is necessary. The aim of this study was to investigate the relationship between mental health dimensions with organizational commitment and work ethics among nurses working in general hospitals affiliated to Tehran University of Medical Sciences. The mental health status among nurses was also investigated.
Materials and Methods: This is a descriptive-correlation study and the study population included nurses from general hospitals affiliated to Tehran University of Medical Sciences. 242 nurses were selected from Vali-Asr, Imam-Khomeini, Baharlu, Sina, and Amir-Alam hospitals using stratified sampling and responded to self-monitoring questionnaires including GHQ-28, Allen & Meyer's organizational commitment (OCQ), and work ethics (Petty, 1995). Data were analyzed using SPSS-23 software as well as Pearson correlation coefficient, ANOVA, one sample t-test, and independent t-test.
Results: Dimensions of social impairment(r=-0/19, p<0/01) and depression(r=-0/33, p<0/01) correlated with work ethics. Dimension of hypochondriasis correlated with nurses organizational commitment (r=-0/15, p<0/05). The mean of dimensions of hypochondriasis (7.45±0.28), anxiety and insomnia (6.97±0.27) and social impairment (6.33±0.19) among female nurses was higher than the average.
Conclusion: The dimensions of mental health of nurses are related to their organizational commitment and work ethics. Also, the mental health status among nurses is undesirable. Therefore, it is essential to address the issues of nurses at high levels, such as the Ministry of Health and the Nursing Organization, and low levels such as hospitals nursing management.

Planning the Nurses' Activities in the Intensive Care Unit of the Farshchian Cardiovascular Hospital in Hamedan with the Help of a Heuristic Algorithm Based on the Gert Method

Parvaneh Samouei

Background: The intensive care unit is one of the most critical parts of the hospital, where the services provided to patients are of great importance. Because nurses have a high volume of work and should respond to patients at the earliest time, the existence of a curriculum is essential. Therefore, proper planning can reduce their fatigue and dissatisfaction caused by the high volume of work.
Materials and Methods: In this research, all activities performed by nurses in the intensive care unit during different shifts for patients, their timing and their GERT network were drawn. The time of each activity was calculated in 4 optimistic time, most likely time, average time and pessimistic time. Also, the total time of activities that can be done by a nurse for one patient from the beginning to the end of the shift can be calculated based on these four modes and an innovative method was used for planning the nursing activities.
Results: The results showed that the total time spent by nurses is significantly different. Therefore, with the help of the proposed algorithm, the activities were allocated to nurses in a way that it created a time equilibrium and significantly reduced the standard deviation and time domain of assigned activities.

Conclusion: The proposed method showed that it is better to allocate patients' work to nurses instead of allocating the patient to the nurse. This will cause all nurses with a fairly equal workload, which can increase the satisfaction of nurses and increase the quality of service.

Multi- objective optimization of scheduling surgeries at surgery room with medical priorities in surgery (Case study: Zahedan Al-Zahra eye Hospital)

Farzad Firouzi jahantigh

Background: According to the importance of health and treatment, it is necessary to use suitable models for planning and setting surgery time. In this study, a mathematical model is offered for operational scheduling of surgeries at surgery rooms of hospitals.

Material and Methods: This is an applied study and its data is related to the surgery rooms of Zahedan Al-Zahra eye hospital. Study population was the surgeries performed in March 2016. The mathematical model of scheduling surgeries at the surgery room was optimized in MATLAB₂₀₁₄.

Results: Due to limitations on patient admission capacity in hospital surgery ward, 79 surgeries were called off. In the proposed model, the total waiting time index for performing surgeries was 1547.29, and this index was found to be 1842 without the use of the model. Therefore, the waiting time index was improved by 16%. In accordance with the third purpose (objective) function, the tally of delays for predicted surgery ending time in one month was estimated to be 69.15 hours. The process of each surgery includes four defined activities. The end time of the activities related to each surgery has been examined and it has been optimized according to the existing limitations.

Conclusion: The proposed model can improve the waiting time by 16% and makes it possible to choose the surgical procedures that should be canceled and delayed according to medical priorities.

Survey on Organizational Culture Based on the Denison Model; Case Study Tehran University of Medical Sciences

sepideh masoud sinaki

Background & Aim: The purpose of this study was to investigate the current organizational culture in Tehran University of Medical Sciences, which is to be considered in order to strengthen organizational culture.

Material & Method: The present study is a descriptive cross-sectional study and an applied research-based survey that was conducted in Tehran University of Medical Sciences in 2019. The sample size was calculated and analyzed using Cochran's formula for 306 people. In this study, Denison's Organizational Culture Questionnaire was used to collect data. Data were analyzed using SPSS software, descriptive statistical methods, one-sample mean and Pearson Correlation Tests.

Results: The average of organizational culture in Tehran University of Medical Sciences, in each component, culture of Involvement (2.29), culture of consistency (2.63), culture of adaptability (2.66) and culture of mission (2.58), Which represented a higher-than-average culture in all aspects of Denison's view.

Conclusion: The organization should do some corrective actions with respect to the components of adaptability (subculture of organizational learning) and Involvement (Capability Development), which has earned a lower score.

Epidemiology and Determine the Causes of Nosocomial Infectioin Teaching Hospital of Tehran: A Cross-Sectional Study

Ghasem Rajabi Vasoukolaei

Background: Nosocomial Infections (Nis) Are Regarded As The Most Common Complications Of Health Cares. These Infections Affect Patient’s Safety in Developing and Developed Countries. The Aim Of This Study Was To Epidemiology and Determine the Causes of Nosocomial Infectioin Teaching Hospital of Tehran In A Teaching Hospital In Tehran.
Materials and Methods: This Cross-Sectional, Descriptive And Analytical Study Was Designed In 2019 At A Teaching Hospital Affiliated With Iran University Of Medical Sciences. The Nosocomial Infection Registry Data between 2017 and 2018 Was Used. The SPSS24.0 Software Package Was Used To Analyze Data Into Descriptive (Frequency, Percentage, Mean and Standard Deviation( And Analytical) ANOVA) Statistics.
Result: The Most Frequent Type of Infections Were Urinary Tract (39.76%), Ventilator Associated Events (20.92%), Bloodstream (20.71%), Respectively. Skin and Soft Tissue Infections (0.7%) Had The Lowest Prevalence. The Highest Incidence Of Nosocomial Infection Was In The ICU With 200 Patients And The Lowest Incidence Was In The ENT With 23.1 Patients And The Overall Incidence Of Nosocomial Infections Was 84.9 Patients Per 10,000 Patient-Days.

Conclusion: Designing The Related Interventions To Control Nosocomial Infections, Making Hospital Managers And Staff To Sensitive In Nis Control, Holding Specialized Training Programs, Considering Basic Design Of The Physical Structure Of Hospital Wards, Considering Attitudinal And Motivational Are The Most Effective Ways To Combat Nosocomial Infections.

A Clustering model for gadgets and apps used in patient monitoring in HIOT environment

MohamadMehdi Sepehri

Background: with increasing demand for treatment, patients are monitored with help of Internet of Things(IOT). Patient's monitoring devices and technologies include heart rate measurement, blood pressure measurement, blood glucose and other vital signs. The purpose of study is to provide a model of clustering patient physical monitoring gadgets and apps in Healthcare Internet of Things (HIOT) environment using data mining techniques, so based on the needs and characteristics of the user, the more appropriate results of choosing technologies acquired.

Materials and methods: This study is a review and functional since its result. The data includes 6 unique features of 60 selected technologies including function, price, connectivity route, power supply, location and type of use that has been extracted from R&D and advertising sites of technologies and also relevant articles. data analysis method is clustering technique and K-medoids algorithm. to identify the most effective features, random forest algorithm has been used.

Results: the proposed clustering model takes into account 6 as inputs and clusters gadgets and apps in accordance with selected characteristics as the model outputs. clustering problem data is clustered in 4 categories.  Silhouette index is 0.45, which indicates the validity of the model. The type of application and then the price had the greatest impact on clustering.

Conclusion: By this model, patients or users can find the most appropriate technology based on the type of disease and other effective features, such as price. So with accurate physical and momentary monitoring, disease progression decrease and prevention of disease will improve.

Hospital strategic planning prerequisties

Parvaneh Esfahani

Background: Strategic planning is an appropriate strategy for improving hospitals’ performance and increasing managers’ responsiveness and accountability. Iranian hospitals were requested to have mandatory strategic plans due to the accreditation requrements since 2012. As a result, they faced several challenges in formulating and implementing strategic plans. Hence, this study aimed to identify the perquisites of hospital strategic planning.
Materials and Methods: This qualitative study was conducted using semi-structured interviews with 47 managers of teaching, private, military, social security and charity hospitals in 2016. Hospitals were selected purposefully from Tehran province hospitals. Content thematic analysis was used for data analysis using inductive approach.
Results: Justifying the need for strategic planning, using an appropriate strategic planning model, training hospital managers and employees on strategic planning process, providing necessary resources, promoting a collaborative and innovative culture, providing incentives for formulating and implementing strategic plans and managers’ and employees’ commitment and involvement are the main prerequisites of strategic planning in hospitals.
Conclusion: Hospitals managers must commit the strategic planning prerequisites prior to formulating and implementing strategic plans. Otherwise, they will encounter several serious challenges.

Computing cost price by using Activity Based Costing (ABC) method in radiology ward of Firooz Abadi hospital

Ebrahim Hasanzadeh

Background: Activity-Based Costing Analyzes the Activities Performed in the Service Delivery Process and Accurately Identifies Costs to Improve The Performance and Efficiency of The Delivery Units and Calculates the Cost of Each Activity by Identifying Services and Activities. The Purpose of This Study Was to Calculate the Cost of Radiology Services Based on Activity Based Costing Method In Firooz Abadi Hospital.

Materials and Methods: This is a descriptive retrospective study conducted in 2018. Data were collected through interview with Hospital officials, direct observation and from existing documents in hospital. Data entry was done through Excel software and analyzed Based on activity-based costing system in eight steps.

Results: Based on the Findings of this Study, Four Types of Imaging Services Were Commonly Found In Firooz Abadi Hospital. From Total Radiology Costs, 79.3% Were Estimated to Be Related to Direct Costs and 20.7% to Indirect Costs. Finally, the Cost Per CT Scan Service Was 725,133 Rials, Mammography 608,054 Rials, Radiology 809,165 Rials and Ultrasound Service 512,692 Rials.

Conclusion: Results of the Study Indicated that Direct Costs accounted for most Costs in Radiology Unit, So Improving Performance and Policies in Health System, Particularly in Human Resource Management, Service Consumption Standardization and Staff Training Suggested to Cost Reduction.