Hospital

Studying The Mental Health Status Of Nurses In The Era Of Covid-19 (A Rapid Review Study In Iran)

Sedighe Sadat Tabatabaei Far

Background and purpose: The COVID-19 pandemic has brought a significant shock to healthcare systems worldwide, including Iran. The mental health of nurses, who have been at the forefront of the fight against the virus, has been profoundly impacted. This study aims to examine the mental health status of Iranian nurses during the pandemic.
Methods: This rapid review was conducted by searching keywords such as "Mental Health," "Nurse," and "COVID-19" in databases including Google Scholar, PubMed, ScienceDirect, ProQuest, Mag Iran, and Civilica. Articles were selected based on their titles, abstracts, and full texts in alignment with the study’s research objectives.
Results: The reviewed studies revealed a range of mental health disorders among nurses working in COVID-19 wards, with stress, anxiety, and depression being the most common. Several factors, such as demographic variables and the specific departments where nurses served, were identified as influencing their mental health. Given that the mental health of nurses affects the quality of care, resilience, and job satisfaction, various strategies have been proposed to improve their mental health.
Conclusion: The findings suggest that the mental health status of nurses is not at an optimal level, and neglecting this issue could lead to long-term harm to the healthcare system and its economic stability. It is recommended that healthcare managers and policymakers implement appropriate measures to address this critical concern.

Evaluation of Laundry Units in Teaching Hospitals of Tehran University of Medical Sciences and Recommendations for Performance Enhancement

Mohammad Amin Zar Foroush

Background and purpose: The laundry unit is one of the most critical support services in a hospital. Optimizing processes and implementing effective management strategies in this unit can significantly impact cost management. This study aims to examine various aspects of hospital laundry units.
Methods: This research was conducted across the teaching hospitals affiliated with Tehran University of Medical Sciences. The study employed a multi-step approach. First, the most crucial performance criteria for laundry units were identified through a fuzzy Delphi technique, consulting 20 experts in the field. These criteria were then weighted using the Step-wise Weight Assessment Ratio Analysis (SWARA) method. Finally, hospitals were ranked using the VIseKriterijumska Optimizacija I Kompromisno Resenje (VIKOR) method.
Results: The analysis of main criteria in the laundry unit revealed the following significance levels: "performance criteria" (56%), "equipment and facilities" (28%), and "cost management" (16%). Among the sub-criteria, "process" emerged as the top priority with a weight of 0.285, followed by "general laundry section regulations" (0.155), "safety and health" (0.139), and "general" (0.081).
Conclusion: The findings highlight the paramount importance of the "process" sub-criterion in hospital laundries. Consequently, we recommend updating guidelines for linen collection, washing, maintenance, and distribution. Furthermore, given that "general laundry section regulations" ranked as the second priority, we suggest implementing clear separation of dirty and clean pathways within the laundry unit and establishing a system for continuous recording and weighing of received garments. These measures can significantly enhance overall process management and cost efficiency.

Staff Management in Social Security Hospitals in Tehran: Challenges and Solutions

Ebrahim Jaafaripooyan

Background and purpose: Effective management of human resources is crucial for improving healthcare services, as personnel are an organization's most valuable asset. This study aims to identify challenges in human resource management and propose solutions to enhance service quality in hospital settings.
Methods: This qualitative study employed semi-structured interviews with 53 managers and key decision-makers from Social Security hospitals in Tehran, using purposive and snowball sampling techniques. Thematic analysis was utilized to analyze the data. The validity and reliability of the qualitative findings were ensured through participant and expert review methods.
Results: The study identified numerous human resource challenges, categorized into five main groups and 20 subgroups. Key issues included flawed recruitment and hiring processes, unfavorable working conditions, weak human resource organization, inadequate staff training, and ambiguity in employment laws and regulations. Proposed solutions, classified into five main groups and 29 subgroups, encompassed: enhancing recruitment and hiring processes, fostering a dynamic organizational culture, improving human resource productivity and efficiency, transforming hospitals into learning organizations, providing comprehensive and effective training, and increasing transparency in rules and regulations, particularly in job descriptions.
Conclusion: Regular identification of human resource management challenges and implementation of evidence-based, scientific, and operational solutions can significantly improve human resource management and, consequently, hospital performance in Social Security hospitals.

Comparing the Global Tariff and Actual Costs of Surgeries at Imam Khomeini Hospital Affiliated with Kermanshah University of Medical Sciences

Nasim Eyvani

Background and purpose: Creating sustainable income, enhancing economic perspectives, optimizing and managing costs, and generating revenue in the health system—especially in hospitals, which are primary providers of medical services—are critically important. These have become priority, vital policies. This study was conducted to compare the recorded costs in patient files with the approved global tariffs for surgeries at Imam Khomeini Hospital in Kermanshah.
Methods: This descriptive cross-sectional study was conducted at Imam Khomeini Educational and Therapeutic Hospital in Kermanshah in 2022. The research population included financial records for surgeries under the global tariff, covering the last six months of 2020 and the first six months of 2021. Data were collected from the Hospital Information System (HIS) and analyzed using SPSS-22 software.
Results: Among 357 cases involving 13 types of surgeries reviewed in this study, tonsillectomy, pterygium, and appendectomy surgeries resulted in losses, while other surgeries were profitable. Considering the average actual cost of each surgery, in 14% of the surgeries, the global tariff was lower than the average actual cost, while in 86% of cases, the global tariff proved beneficial to the hospital.
Conclusion: Although most centers that apply the global surgery tariff are financially unprofitable, implementing operational plans based on essential resources and designing corrective actions to reduce global costs—particularly by managing patient length of stay—can improve efficiency and productivity.

Investigating The Competence Of Spiritual Care Among Nurses Working In Teaching Hospitals Affiliated With Shahid Sadoughi University Of Medical Sciences In Yazd, 2023

Neda Futuhi Tafti

Background and purpose: Nurses, as the closest healthcare providers to patients, hold significant popularity and trust. Strengthening their competence in spiritual care is critical in ensuring holistic healthcare delivery. This study aimed to evaluate the spiritual care competence of nurses working in selected teaching hospitals of Shahid Sadoughi University of Medical Sciences in Yazd in 2023.
Methods: This cross-sectional study was conducted on 262 nurses employed in three selected teaching hospitals (Shahid Sadoughi, Shahid Rahnamoun, and Afshar hospitals). Data were collected using the Standard Spiritual Care Competence Questionnaire (SCCS) and analyzed through ANOVA, Mann-Whitney, Kruskal-Wallis tests, and Spearman's correlation coefficient using SPSS version 21 software.
Results: The overall mean score and standard deviation of spiritual care competence among nurses were 83.9±18.2, indicating an optimal level of competence. Among the dimensions of spiritual care competence, the "personal support and consultation with the patient" dimension scored the highest (18.8±5.2), while the "communication" dimension scored the lowest (7.3±1.6). The highest overall competence score was observed at Shahid Rahnamoun Hospital (88.5±17.7)
Conclusion: While the overall competence in spiritual care among the nurses studied was favorable, the low score in the communication dimension highlights the need for workshops focused on effective nurse-patient communication. Developing these skills can significantly enhance nurses' roles in improving patient health outcomes.

Explaining the Factors Affecting the Competence Development of Managers in Public Hospitals with an Approach Based on the General Policies of the Health System

Mohammadreza Rabiee Mandejin

Background and purpose: The implementation of key components in the selection of meritorious candidates, ensuring they possess the necessary capabilities for key and sensitive positions, and adhering to the principle of meritocracy in the distribution of power and division of duties and responsibilities among society’s elites, not only contributes to the stability, growth, and development of the country but is also one of the secrets to the success and longevity of leaders. Therefore, this article aims to explain the factors influencing the competence development of public hospital managers, guided by the general policies of the health system.
Methods: The research was developmental in purpose and qualitative in method, utilizing thematic analysis. The statistical population included books, articles, documents, and knowledgeable human resources, comprising government management experts, hospital managers with a master's degree or higher, and at least ten years of experience in hospital management. The study employed a purposive approach with semi-structured interviews, continuing until theoretical saturation was reached (16 interviews)
Results: A total of 18 competence development factors were identified, categorized into 75 components and 671 dimensions. The implementation of the Strauss-Corbin model revealed that causal conditions included leadership, doctors, and staff. Intervening conditions encompassed the economy, research technology, and education. In addition to goals and missions, organizational platform, creativity, services, and structure were considered contextual conditions. Human resource management, public relations, and religion were identified as strategies, while the resulting consequences were classified into expertise, a knowledge-based economy, and internationalization.
Conclusion: According to the research findings, it appears that to advance, upgrade, and excel in hospitals that play a critical role in the health of society, these identified factors can be utilized to enhance the competence of public hospital managers.

Evaluation of the Economic Efficiency of Radiology Units in Hospitals Affiliated with Shahid Sadoughi University of Medical Sciences, Yazd

Ebrahim Bahrami Nia

Background and purpose: Radiology departments are among the most critical units in hospitals due to their significant role in diagnosing and treating diseases. Given the high cost of radiology equipment and the revenue these departments generate, improving service delivery and enhancing efficiency are of paramount importance. This study aimed to evaluate the economic efficiency of radiology units in hospitals affiliated with Shahid Sadoughi University of Medical Sciences, Yazd.
Methods: This descriptive-survey research was conducted as an applied study. Data on input and output variables were collected from nine hospitals under Shahid Sadoughi University of Medical Sciences. Input variables included the number of expert staff, the number of radiologists, the number of radiology devices, and the number of CT scan devices. Output variables comprised the number of admitted patients, the number of registered radiological images, and the total revenue generated.
Results: The average technical and scale efficiency score was 0.910. Among the radiology units studied, 55% were found to be economically inefficient. Shahid Sadoughi Hospital exhibited decreasing returns to scale, while Shahid Beheshti Taft, Khatam al-Anbia Abarkouh, Waliasr (AS) Bafq, and Ziaei Ardakan hospitals showed increasing returns to scale. Additionally, Dr. Rahman, Afshar, Fatemeh Al-Zahra (S) Mehriz, and Imam Jafar Sadiq (AS) hospitals demonstrated constant returns to scale.
Conclusion: Eliminating surplus manpower, based on the results of the Data Envelopment Analysis (DEA) method, plays a crucial role in reducing hospital and healthcare sector costs and enhancing hospital efficiency.

A Look At Mandatory Overtime Nursing In Iran

Adel Eftekhari

Nursing is one of the most sensitive and important jobs in the health system, which in recent years has led to dissatisfaction and strikes among nurses due to the increasing demand for services, shortage of nursing staff, and forced overtime. This study aimed to look at the causes and consequences of forced overtime among nurses.