Journal of

---

Background: Approximately, more than 60 percent of the hospital costs allocate to hospital human resources. The study aimed at determining the number of nurses in the poisoning department of a general hospital in Shiraz.

Methods: This study was an applicable one based on hospital information.  Study population was patients who referred to a hospital poisoning department of Shiraz in 2012.  The medical records were checked up. Monthly stratified data was obtained from the statistics office and patient records (physician's orders and nursing notes) using a monthly systematic data collection randomly. Linear programming techniques using lingo version 8 software were performed to data analysis in order to calculating appropriate number of nurses.

Results: Two nurses in morning, two in evening, three in night and seven in all shifts were at least required nurses in the poisoning department of the general hospital. The number of available nurses was more than estimated number in the department.

Conclusion: The numbers of nurses were over the approximated number in the department in morning and evening shifts.  Besides, the estimated of nurses from quantitative methods such as linear programming were lower than those calculated experimentally by nursing managers. It is recommended to Hospital administrators considering these techniques calculation to achieve appropriate distribution of staff in departments.

---

Background: The subjects' demographic characteristics are factors influencing their viewpoints about healthcare quality and have a positive association with the clients’ satisfaction. This study aimed at investigating the role of demographic variables on medical tourists' viewpoints about service quality of hospitals in Shiraz.

Materials and Methods: This descriptive-analytical and cross-sectional study was conducted on 200 foreign patients who referred to Shiraz hospitals during the first six months of 2013. Data collection tool was a questionnaire consisting of two parts. In the first part, medical tourists' information was collected and in the second part, their expectations and perceptions of services quality were measured using adapted SERVQUAL scale. The validity was checked out by experts and reliability confirmed by Cronbach’s Alpha test for expectations and perceptions separately (90% and 89%).  Finally, data analyzed through SPSS v.16 software using independent t-test and ANOVA.

Result: According to the results, the mean score of the quality gap was estimated -0.26 for people over the age of 50 years, as it was lower than other groups. Also, the lowest total values of this quantity were related to the individuals with low level of literacy and those who stayed less than 7 days for treatment which were estimated -0.32 and -0.36 respectively. In addition, based on statistically significant dimensions, married tourists, people from Oman and those who had received eye surgery had lower gap mean score than the other patients as their total values were estimated -0.42, -0.21 and -0.22, respectively.

Conclusion: In order to develop the medical tourism industry, the demographic characteristics of the subjects should be considered in policy making and service design which can be result in majority satisfaction.

---

Background: Reduction of errors is necessary to improve the quality of healthcare, promoting communication between the hospital staff and patients, and decreasing the patient's complaints in hospitals. Due to the high probability of error in the operating room (OR), this study aimed to detect the potential errors in the OR of Nemazee hospital using FMEA.
Materials and Methods: This study was a qualitative one which assessed Failure Mode and effects of OR in six steps using FMEA technique. At First, the OR activities were listed, then the failure modes were recognized. Next, the Risk Priority Number (RPN) of each error was calculated according to the indicators of Occurrence (O), Severity (S) and Detectability (D).
 Results: Totally,204 failure modes in 36 activities in five process in surgery ward were recognized.15.7 percent of failure modes classified as high risk factors (RPN ≥ 100). The most and the least distribution of origin factors were related to human and organization and technical errors, respectively.
Conclusion: The majority of errors in OR was set in of human skills category. Besides, the most and the least failure modes were belonged to “patient anesthesia by circular activity number 20, RPN=1795.23)” and “not to oxygenation for patients (the activity number 36, RPN=99.33) respectively. Identification of 36 activities and 204 errors in the 5 processes of Operating Room represents the comprehensiveness of HFMEA method in the identification, classification, evaluation and analysis of the health system errors.  
 

---

Background: Communication is one of the central concepts and an integral part of the nursing profession. This study aimed to determine the effect of communication skills training of nurses on patient satisfaction with nursing staff services in teaching hospitals affiliated to Shiraz University of Medical Sciences.
 
Materials and Methods: The Comparative study carried out in 2017. The research population included nurses from educational hospitals and patients referring to them. Four hundred patients were selected through convenience sampling method and one hundred trained nurses and one hundred untrained nurses were randomly chosen. The data collection instruments were a standard questionnaire. Data were analyzed in SPSS₂₃ using T-test, ANOVA, Tukey test, and Pearson correlation coefficient at α = 5% level.
 
Results: Mean scores of nurse-patient commination and satisfication of nursing services among patients under care of trained nurses were 93.5 ± 21.08 and 176.24 ± 22.14 and mean score of patients under care of untrained nurses the scors 81.76 ± 18.83 and 166.36 ± 41.10, respectively. A significant direct correlation was found between nursing-patient commination score and patient satisfaction score (P= 0.023, r= 0.681). Patients under the care of trained nurses were more satisfied with nursing services than those served by untrained nurses (P= 0.012). The results revealed that patient satisfaction had a significant relationship with age (P<0.001) and marital status (P₌0.031).
 
Conclusion:  Implementation of communication skills training courses for nurses leads to improved patient satisfaction. Hospital directors are recommended to consider holding regular communication skills training courses for their nursing staff.

---

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.