Journal of

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Background: Job Burnout is one of the important factors to reduce productivity, making mental and physical adverse effects on jobs related to human services and losing efficient manpower by considering the important role of nurses in the health care systems. This study has been done to survey the association between mental health and job burnout syndrome among nurses' staff in training hospitals in Qom province.

Materials & Methods: This is an analytic-descriptive study which has been performed among 200 nurses personnel in the training hospitals of Qom province with applying proboblity multistage statistical method.Three quetionnaires including demographic data,general health and Maslach,s Burnout questionnaire (Inventory) were used to data gathering by which validity and reliability were certified in the previous studies. Data analyzed by SPSS18. Descriptive statistics such as frequency, percentage, inferential statistics (Chi-square test and correlation coefficient of spearman and pearson) and also man-whitney test applied.
Results: Average score of job burnout was 60.8. Respecting general health, 53% of nurses was in danger. Average score of emotional fatique,the personalization and personal accomplishment was 27.2,12.17 and 21.7,respectively. 50 percent of nurses had physical dysfunction,44.5% suffered from anxiety and sleep disorders, 32.5 and 44.5% had social dysfunction and depression, respectively. There was a significant correlation between burnout syndrome and general health. Based on the spearman correlation test, there was a significant correlation between emotional fatique and physical disorders, anxiety and sleep disorders and social dysfunction.
Conclusion: Regarding srtessful nature of nursing job and high prevalence of disorders in general and mental health of nurses incomparision to others and also high prevalence of burnout among nurses in Qom province,it is nesecary to decrease these sort of problems through applying arrangements such as enhancing motivation, increasing work stability, increasing job satisfaction, clearance in how individuals respond to take actions and tasks division among personnels to reduce workload.

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Abstract Background: Family physician plan is a form of health care delivery system which its correct implementation results in health promotion. Being aware of family physicians’ viewpoints towards their occupation would play an important role in its better implementation. The present study aims to to investigate family physicians` attitude who are working in health centers affiliated with Tehran University of Medical Sciences towards their profession. Materials and Methods: This qualitative study was conducted in 2011. In order to reach information saturation , the data were collected by performing two singular interviews and four focus group discussions among all 33 physicians working at health care centers of Tehran University of Medical Sciences. Eventually, data were analyzed using conceptual framework method. Results: Data analysis indicated three general concepts. The first issue is the factors that encourage physicians to choose family physician profession and continue doing it (including economical, cultural and environmental factors and work conditions). The second one is the study challenges (including preparation to implement the plan, work conditions and professional limits) and the final one is the reforms needed for its correct and proper implementation ( in policy making and administrative level). Conclusion: Regarding the issue that economical, cultural and environmental factors and work atmosphere have the main role in motivating family physicians, the most important challenges the plan confronts are also related to these factors and major and minor reforms are needed to overcome these challenges. Moreover preparing society’s culture would surely result in better implementation of the plan.

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Background: Hospital waste need a very sensitive and cautious attention due to holding hazardous, toxic, and pathogenic factors such as infectious, pharmaceutical, pathological, chemical and radioactive left-overs. Thus, this study aimed to evaluate the observance of safety measures by workers responsible for collecting hospital wastes in the public hospitals affiliated to Tehran University of medical sciences. Methods and Materials: This cross-sectional and descriptive-analytic study was conducted in 1391. Data were collected through using a questionnaire. According to the frequency distribution, total score for participants was divided into three weak (<26), average (26-30), and high (>30) categories. Data were analyzed by the SPSS 18 software using T-Test, one-way ANOVA and regression analysis. Findings: Based on the results, 33.3% of hospitals received suitable, 55.5% received average and the remaining (11.2%) received a weak score regarding safety measures. Moreover, there was a statistically significant correlation between cleaning staff’s characteristics (education, age, work experiences and their training) with their safety status score. Conclusion: Implementing current national principles and standards and conquering shortages, proper planning, using young workers alongside with experienced ones, more training courses and respecting and paying enough attention to cleaning staff would help to improve the safety of collecting hospital wastes.

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Background: ‌ Based on increasing the privatization in hospitals, conducting researches in various fields of private hospitals and comparison with public hospitals is greatly felt.This study aimed at investigating the relationship between job satisfaction and burnout among employed nurses in selected public and private hospitals in Shiraz city.

Materials and Methods: This was a comparative-correlational study. The study population was composed of employed nurses in public and private hospitals in Shiraz city in 2012. sample size was estimated 320 using Cochran formula. The questionnaire of Spector job satisfaction” and “Maslach burnout” were used for data collection. Study conducted in two private and two public hospitals in Shiraz and data gathered randomly among nurses. In order to analysis descriptive and interfere statistics including mean and standard error, Pearson correlation coefficient, MANOVA and independent t- test.

Results: There was a significant and negative relationship among job satisfaction and three dimensions of job burnout in both public and private sectors (p<0.001). In addition, the results revealed that there was a significant difference among the emotional exhaustion and depersonalization between private and public sectors (p<0.05).  However, there was no significant difference between job satisfaction and reduced productivity performance of these two sectors.

Conclusion: According to the findings, by increase in the nurses' job satisfaction, particularly in the public sector, the adverse effects of burnout can be prevented.

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Background: This study was conducted to validate the "staff attitude toward the use of coercion in the treatment of mentally ill patients" questionnaire and assessed their attitude in selected public psychiatric hospitals in Tehran city.
Materials and Methods: This is a descriptive and analytical study which was carried out on three hospitals of Tehran University of Medical Sciences, Iran University of Medical Sciences and social welfare and Rehabilitation University in 2015. The questionnaires were distributed to the participants and finally 273 questionnaires were used.  Data were analyzed using confirmatory factor analysis test. Moreover, ANOVA and independent t-test were applied to evaluate the participants' attitude on using coercion for treatment of mentally ill patients.
Results: Study findings revealed that 61% of participants were nurse and 11% were physicians. According to the study results, three final obtained factors explained 61.93% of the total variance; this variance reflects the proper and appropriate selection of the questions.  In addition, there were statistically significant differences between marital status and offending attitude domain; between job and education and offending attitude; and security and treatment domains.
Conclusion: The current questionnaire has a high validity and reliability and is also appropriate for the context of Iran.  The attitude of the studied participants was a bit towards using coercion in treatment of mentally ill patients. Therefore, it is recommended that authorities take some steps toward changing health services providers' attitude of using coercion. 

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Background: Length of stay is one of the most important and practical indices used in hospitals today which represents the performance and efficiency of the hospitals. This study aimed to identify the factors affecting length of stay in hospitals affiliated to Tehran and Iran Universities of Medical Sciences based on Hierarchical Analysis Technique.
Materials and Methods: This descriptive cross-sectional study was conducted in 2013. Study population consisted of 40 participants using purposive sampling method in the two groups including 13 matrons (nursing managers) and 27 supervisors (Clinical and educational) of hospitals affiliated to Tehran and Iran Universities of Medical Sciences. Data collection tool was the paired comparisons questionnaire which was confirmed validity by experts using Lawshe and reliability by Inconsistency Ratio. Data analysis was performed using Expert Choice software version 11.
Results: In general, in the studied hospitals, study results revealed that the "diagnostic, treatment and care methods (treatment efficacy)” with the mean of 21.4% and "admission and discharge in the end days of the week and the days off” with an average of 0.36 were the highest and the lowest priority is given to other factors affecting the length of stay of the patient,respectively.
Conclusion: Efficacy of provided treatment through using equipment, appropriate diagnostic and therapeutic procedures and factors related to hospital manpower were effective on length of stay in quantitative and qualitative dimensions. These important issues need more planning and pay attention by hospital officials.

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Background: Administrative violations of employees at their workplace create a conflict between individual and organizational goals. Due to the long process of handling these violations, this study aimed to identify and present some suitable solutions in order to reduce delay in the health sector.
 
Materials and Methods: This study was carried out at three steps. At the first step, causes of delay in handling of administrative violations were extracted along with the proposed solutions using interviews. In second step, Delphi method was applied in order to find out the agreement of experts on the suggested solutions. In third step, practical solutions were prioritized using the analytic hierarchy process.
 
Results: Overall, 23 out of 39 solutions were certified  after consultation with experts running the first round of Delphi using the interview. These solutions were presented to 15 experts using a self-constructed questionnaire and 18 solutions were approved by the experts finally.Solutions were divided into six groups of motivational, organizational, administrative, process, and research group solutions.
 
Conclusion: Training as the main key to prevent the delay can work effectively at all levels and processes of service delivery. Hiring well-informed and conscious managers at various organizational levels as well as having experienced and mindful research group on administrative violations can speed up the process of handling these violations.

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Background: Administrative violations are a person-centered behavior that violates the accepted organizational norms, and thus, can threaten the organization health. Therefore, the present study aimed to identify the causes of prolonging the time of taken to deal with administrative violations were at the staff of Ministry of Health and Medical Education.
 
Materials and Methods: This study was a qualitative content analysis one. For sampling, convenience, purposeful and snowball sampling methods were used. The sample size continued to saturate the interview data with each group of people. Data collection was performed with open questions and interviews using semi-structured interviews. Finally, all interviews were analyzed using MAXQDA software.
 
Results: After implementing and data analysis, the causes for prolonging the time spent on administrative violations in primary and recruiting boards were divided into five main categories including "member characteristics"; "actual proceedings"; "Inevitable factors"; " legal factors "and" organizational factors".
 
Conclusion: According to the findings and experts’ opinions, the most problems in the process of handling administrative violations are related to the time lag in the notification process, investigation and expertise. Membership training, teamwork, and the use of members with different expertise can prevent employees from handling administrative offenses.
 

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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.

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Background: Performance appraisal and quality evaluation of the services provided will achieve the organizational goals and improve the level of staff capability. In order to evaluate accurately and efficiently, we need to use standard indices, to compare the quality and quantity of work with standards, to know the current conditions and to solve its problems
 Methods: This study is an applied study. This was done through a combined method of reviewing the texts and consensus of experts. Initially, the literature review and emergency evaluation indices were extracted, then the duplicate indices were removed and similar indices were merged, then weighted experts and questionnaires were compiled with the indices. Content validity, Cronbach's alpha coefficient and test-retest were used to assess the validity, internal consistency and reproducibility of the questionnaire, respectively. Data were analyzed using Excel and SPSS 20 software.
 Finding: Final questionnaire with 105 questions in 8 areas including management and leadership (15); human resources (22); physical space and facilities (18); medicine and medical equipment (6); guidelines and policies (17); patient-centered (10); documentation of patient records (5); quality and time indices in the emergency department (12). The results showed that the final questionnaire was reliable (0.89) and repeatable (ICC = 0.98).
Conclusion: The Hospital Emergency Performance Assessment Questionnaire is a valid and reliable instrument and can be used to evaluate the performance of hospital emergency services.

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