Journal of

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Abstract Background: Hand hygiene is the simplest and most effective preventive measures to reduce cross infection in hospitals. However, compliance with recommended instructions is commonly poor among healthcare workers. The present study aimed to explore potential behavioral determinants of hand hygiene compliance among healthcare workers in intensive care units. Methods and Materials: A qualitative study was conducted, consisting of 42 semi-structures interviews with physicians (attending physicians, non-attending physicians, residents), nurses, nursing students and medical students, who worked in the intensive care units. Results: Participants mentioned self protection as the main reason for the performance of hand hygiene. According to the participants, hand hygiene was often performed after direct contacts and tasks that were perceived to be dirty. Participants were most concerned about knowledge gaps in hand hygiene practice. Most participants believed that having a good theoretical knowledge of hand hygiene guideline may strengthen healthcare workers' attitudes toward hand hygiene. Junior practitioners believed that the superiors' hand hygiene practice could influence their performance both negatively and positively. Participant also believed that the lack of formal and informal control may hinder compliance among healthcare workers. High workload, interruptions, and limited access to hand hygiene products were mentioned as primary barriers to hand hygiene. Conclusion: The findings revealed that a number of factors can influence had hygiene practice. Recommendations of the current study are of value to future researches aiming to improve compliance with hand hygiene behavior among healthcare workers.

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Background: The complexity and intensity of environmental fluctuations combined with unexpected accidents and dangers have increased the probability of hospital supply chain disruptions. Supply chain resilience has been suggested as a strategy for dealing with such challenges and for continued provision of appropriate and efficient services in hospital at the time of disaster. The present study intends to identify the factors influencing hospital supply chain resilience.
Methods and Materials: This qualitative study was based on the content analysis of semi-structured interviews with 14 experts in the university hospitals in Bandar Abbas in 2018. Participants were selected through purposive and snowball sampling. The interviews continued until data saturation was reached. The obtained data from interviews were coded and analyzed using MAXQDA Software.
Results: After analyzing the data, the factors influencing hospital supply chain resilience were identified and classified into six main components and 30 themes. The main components included: staffs’ attendance, suitability, infrastructures safety, disaster management, support and capacity systems, and external factors.
Conclusion: Based on the obtained results, it can be concluded that staff training, disaster management planning, command system, and surge capacity are the key factors influencing hospital supply chain resilience. Therefore, they should be taken into consideration while planning to promote hospital supply chain resilience.
 

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Background: Scenario planning is one of the most crucial future study methods in uncertain and complex situations. Hospital supply chain resilience also requires an understanding of future events due to the complexity of relationships and exposure to unexpected circumstances. The purpose of this study is to formulate scenarios for the future development of hospital supply chain resilience.
Materials & Methods: This research is the second stage of research with a mixed approach, and it is in the category of normative scenarios based on intuitive logic. Participants in this study were purposefully selected from the experts of two hospitals. In the first phase, the impact-uncertainty questionnaire and the effect-uncertainty diagram were used to determine the critical uncertainties. After forming the scenario team, based on the impact diagram and the scenario matrix, The cause and effect relationships of the variables were determined in the second phase.
Results: Drivers of Hospital supply chain resilience were clustered into 14 main categories, and the results of the impact-uncertainty diagram showed that "people's culture" and "accident nature" play a more significant role in scenario development as critical uncertainties. Four scenarios were developed based on the opinion of experts for these two drivers.
Conclusion: four scenarios, "compatible," "turbulent," "broken," and "combative," were developed based on the critical drivers in supply chain hospital resilience. Use the inspirational feature of these scenarios can help managers in health and crisis management be more prepared to face the crisis. Scenarios based on intuitive logic can be used for futures studies in other areas of the health system.