Showing 251 results for Hospital
Marziyeh Najafi, Morteza Nazari, Hojjat Rahmani, Ghasem Rajabi Vasokolaei, Behrooz Pouragha, Sima Feizolahzadeh, Roya Rajaee,
Volume 21, Issue 4 (1-2023)
Abstract
Background and purpose: One of the main challenges of human resource management in hospitals is the proper distribution of nurses, which is necessary to improve the efficiency and quality of health services. In this review, this rate is compared in selected countries and Iran in order to provide the necessary evidence for managers and policymakers in human resource management
Materials and Methods: This study was conducted as a field review in 2019 with the aim of comparing the standards of nurse distribution to beds/wards in selected studies. The search was conducted with related keywords in "Scopus", "Web of Science", "PubMed" databases without a time limit.
Results: The distribution of nursing per bed was reported in Australia, England, Northern Ireland, Wales, Israel, America, California, Pennsylvania and New Jersey. In Iran, the rate of nurses to intensive beds was slightly higher than the average and the ratio of nurses to ordinary and emergency beds was lower than the average of selected countries average.
Conclusion: Nurses' distribution was generally lower than the average of other countries, and this ratio was lower in some sectors and higher than the average in some sectors. Recruitment and redistribution of the appropriate nurse in different sectors by benchmarking successful countries are suggested.
Mohammad Zarezadeh, Ashkan Amraeei, Mohammad Sadegh Abolhasani,
Volume 21, Issue 4 (1-2023)
Abstract
Background and purpose: This research was conducted with the aim of determining the relationship between the implementation of the strategic plan and the performance of the hospital. The importance of knowing the factors affecting the implementation of the strategic plan and its identification leads to better planning and the correct implementation of the strategic planning process.
Methods: The current research is a descriptive analytical research, in terms of cross-sectional time and practical results, and it was carried out in 2018. The research population is all the people who have played a role in the drafting of the strategic plan. This research has used the census, which filled the questionnaire in a high percentage of the statistical population. After collecting the data, the information was entered into the software and SPSS version 16 software was used to analyze the data.
Findings: The relationship between the implementation of the strategic plan and the performance of the hospital is direct and strong. Among all parts of the strategic plan, customer management plays a more important role than other parts of the strategic plan in improving the performance of the hospital.
Conclusion: In order to have optimal performance in a hospital, we need detailed strategic planning, and this plan must be implemented carefully and properly monitored so that it can bring us optimal performance.
Naser Seifollahi, Seyed Ali Naghavi,
Volume 21, Issue 4 (1-2023)
Abstract
Background: Nowadays, the medical tourism market is one of the most profitable and competitive industries in the world, and it is one of the new developed fields of tourism. Advertising is one of the methods of increasing tourist attraction and influencing tourists' decision-making to choose a destination. The present research aimed to simulate the effect of advertising on the attraction of medical tourists in the hospitals of Yazd city.
Materials and methods: The present research is applied in terms of research objective, and in terms of methodology, it is in descriptive-analytical research. The statistical community was formed by university professors and experts in the field of medical tourism, and managers of hospitals and medical centers in Yazd. The snowball method was used for sampling. Information was collected through text reviews, questionnaires and semi-structured interviews with experts. The integrated and innovative approach of factor-based modeling and Taguchi method was used for data analysis, and the software used was AnyLogic and MiniTab.
Results: The results of the scenario execution revealed that among the advertising tools, internet advertising is more effective, and television ads, specialized tourism magazines, and seminars and conferences are in the next ranks. As the final output of the research, the investigation of the main effects related to each advertising tool led to identification of the suitable level of each tools and the presentation of the most favorable scenario based on the advertising program of Yazd hospitals.
Conclusion: Based on the fact that among the advertising tools, internet advertising has the greatest effect on attracting medical tourists, hospital management should pay special attention to internet advertising to attract more tourists in the field of medicine. In this way, more information will be provided to tourists and the demand for medical tourism will increase.
Hossein Rahimi Klour, Seyed Ali Naghavi,
Volume 22, Issue 1 (5-2023)
Abstract
Background and objective: As a critical factor for hospital effectiveness, agility uncovers the way such organizations react to internal and external changes. From this perspective, the present study was to design an agent-based model to simulate organizational agility development in the hospitals of Ardabil Province, Iran, in view of the effective factors.
Materials & Methods: Utilizing an exploratory, mixed-methods research design, this study was performed in accordance with inductive-deductive reasoning. For this purpose, the samples included 10 theoretical and experimental experts, selected by purposive sampling of the non-probability type. As well, the data collection tools were interviews and questionnaires. During the qualitative phase, the main factors affecting organizational agility were initially isolated using thematic analysis. Afterward, the given factors were prioritized with the fuzzy Delphi method in the quantitative phase. Ultimately, the model for organizational agility development was simulated through the agent-based approach.
Results: With reference to the study results, 50 primary codes, 15 sub-themes, and 5 main themes were identified, and then “influence in management” was acknowledged as the most significant one shaping organizational agility. Besides, the simulation outputs demonstrated that the proposed model could provide the right estimate of the future of organizational agility development in the hospitals of Ardabil Province, Iran.
Conclusion: Along with the study results, hospital managers are suggested to reflect on the effective factors identified here to better fulfill organizational agility development.
Mohammadreza Zahedi, Seyyed Mahdi Hosseini Sarkhosh,
Volume 22, Issue 2 (9-2023)
Abstract
Background and purpose: The Internet of Things (IoT) essentially refers to the connectivity of various objects through the internet to facilitate a more efficient and intelligent experience. However, due to the emerging nature of this technology in Iran, instances of its full deployment in service organizations, including hospitals, are rare or infrequent. Therefore, the aim of this study is to identify the key success factors for the deployment of IoT and assess the readiness for implementing this technology in Milad Hospital, Tehran.
Methods: This research is a descriptive-survey study conducted in two phases. In the first phase, 30 key success factors were identified through a review of previous studies. In the second, survey phase, 93 managers and staff members of Milad Hospital formed the statistical population, and data was collected through a researcher-made questionnaire. The comparison of the current and ideal states of success factors for IoT implementation, and their ranking, were done using the t-test and Friedman test in SPSS software.
Results: Based on this study, factors such as information technology, organizational culture, organizational structure, and human resources were identified as the most crucial for successful IoT deployment in the hospital. Additionally, the results showed that there is a significant gap between the hospital's current state and the desired state for IoT implementation in these identified areas.
Conclusion: Successful implementation of IoT requires enhancement in readiness, both in terms of technological and organizational-cultural infrastructures
Atefeh Tasht Zar, Malike Beheshtifar, Reza Zare, Amin Nik Pour,
Volume 22, Issue 2 (9-2023)
Abstract
Background and Purpose: The purpose of this study is to validate the model of organizational evolution in hospitals affiliated with the Bushehr University of Medical Sciences.
Materials and Methods: This study was applied in terms of its purpose and quantitative in terms of its implementation method, employing a structural modeling approach. The statistical population in this part of the research included all managers, deputies, and experts in the field of the subject studied in Bushehr hospitals, totaling 130 individuals. A sample size of 100 was determined using Morgan's table and was selected via simple stratified random sampling. The research tool was a researcher-developed questionnaire. The questions and items of the questionnaire were compiled using research literature, theoretical foundations, and the results of a qualitative study. The face and content validity was confirmed by experts, and its reliability was obtained with a Cronbach's alpha method result of 0.976. Data were analyzed using the structural equation modeling method in SMART PLS software. Results: The findings of this research demonstrated that the structural model of organizational evolution has 43 sub-components across six components: causal conditions, background, mediating, central phenomenon, strategies, and outcomes. All variables obtained can be considered in the design of the final model. In conclusion, the effectiveness of each variable was discussed and analyzed from an existential perspective. The results indicated that the causal conditions, background conditions, intervening factors, and outcomes in the model of organizational evolution in hospitals affiliated with Bushehr University of Medical Sciences were significant.
Conclusion: The results showed that the model of organizational evolution in hospitals affiliated with Bushehr University of Medical Sciences is valid.
Sanaz Zargar Balaye Jame, Nader Markazi Moghaddam, Hesam Sharifnia, Mehrdad Khoshian,
Volume 22, Issue 3 (12-2023)
Abstract
Background and Purpose: Medical imaging is one of the most expensive sections of a hospital due to the use of superior technology, specialized personnel, and adherence to special protective regulations, all of which have a direct impact on the diagnosis and treatment of diseases. Time-driven activity-based costing (TDABC) provides an overview of hospital activities, enabling the identification and management of costs and resources with greater accuracy and ease. The purpose of this study is to examine the total costs of services and the unused capacity of resources to provide financial management solutions for hospital administrators.
Materials and Methods: This descriptive and retrospective study was conducted on the statistics and accounting data of a general hospital in Tehran in 2018. The study falls under the category of applied research due to the potential use of the results in financial management and resource consumption. The data collection method included the review of documents and financial statements, timing of all activities in the imaging department, and calculations based on the time-driven activity-based costing method, using Excel software, with the elimination of the cost of unused resources.
Results: The study found that the total cost was mostly below the approved tariffs, with the main cost components being 34% manpower, 23% overhead, 22% equipment, and 15% consumables. The findings indicated that only 58% of resource provisioning expenses played a role in determining the total cost of services.
Conclusion: The findings of this research suggest that reducing the unused capacity of resources and organizational reforms can decrease the total cost of services, increase profitability, and optimize resource usage to enhance the quality of hospital services.
Amir Fazel, Behnam Karamshahi, Azin Harandi,
Volume 22, Issue 3 (12-2023)
Abstract
Background and Purpose: Today, the use of strategic management accounting techniques within organizations is expanding rapidly. However, the implementation of these techniques and the examination of variables affecting them in hospitals remain largely unexplored. The aim of this research is to investigate the impact of accountants' networking on the use of strategic management accounting techniques, considering the moderating roles of hospital information systems and organizational culture.
Methods: This descriptive-correlational study utilized a 43-question questionnaire, whose validity and reliability were confirmed. The statistical population consisted of all employees and accountants in the finance and accounting departments of hospitals in Kerman, totaling 141 individuals. The census method was used to complete the questionnaire, with 139 questionnaires returned. Structural equation modeling and Smart PLS 3 software were used to test the research model.
Results: Statistical indices confirmed the model's appropriate fit (GOF=0.738). Networking of accountants, hospital information systems, and results-oriented culture positively influence the use of strategic management accounting techniques, whereas innovative culture has no effect. Additionally, hospital information systems and results-oriented culture positively moderate the relationship between accountants' networking and the implementation of strategic management accounting techniques, while innovative culture does not have any moderating effect.
Conclusion: This research contributes to the expansion of strategic management accounting techniques in hospitals and highlights the importance of influencing factors. Hospitals should apply these techniques while giving due consideration to the factors that affect them.
Roholah Hosseini, Mohammad Reza Zaman Parvar Barkosrai ,
Volume 22, Issue 3 (12-2023)
Abstract
Background and purpose : Managers, as the most important organizational decision-makers, have a significant and decisive role in the success and development of hospitals. Competency models help hospital managers to apply the knowledge, skills, and experiences needed to fulfill their responsibilities and mission. It helps them to do their jobs more successfully. The purpose of this study is to design a management competency model in order to optimize management systems in Karaj hospitals.
Methods: The current research is based on a quantitative approach, and in terms of its purpose, it is an applied research type, and in terms of data collection, it is a survey type. The statistical population of his research was all employees and medical staff in the hospitals of Karaj city. The sample size is 384 people and stratified random sampling method was used.The data was collected using a researcher-made questionnaire whose validity was confirmed by experts. The software used in this research is SPSS22 and AMOS.
Results: According to the findings The impact of the six main dimensions of the management competency model included Knowledge competence (1.02), personal competence (0.98), interactive competences (0.38), executive competences (0.51), value and moral competences (0.42) and in The maximum job qualifications (0.41) were determined.
Conclusion: Based on the findings The impact of knowledge and personal competence on management competence in hospitals is higher than other dimensions. In other words, management competence in the hospital is highly dependent on the knowledge and personal competence of managers. Also, based on the goodness of fit index, the hospital management competency model was modified and evaluated within the standard. It is suggested to provide the basis and preparations for the implementation of the model for appointing competent managers and improving the competence of the hospital management system.
Mohammadreza Shahraki, Hamidreza Esmaeili,
Volume 22, Issue 4 (1-2024)
Abstract
Background and Purpose: Artificial intelligence (AI) plays a crucial role in the optimal management of hospital waste, particularly in predicting the volume and type of waste generated. This study aims to identify and rank the risks associated with the use of AI systems in hospital waste management by employing a multi-criteria decision-making approach.
Methods: This descriptive, cross-sectional study was conducted in 2023 (1402 in the Iranian calendar) at two hospitals, Ali Ibn Abitaleb and Khatam al-Anbiah, in Zahedan. Ten hospital staff members were selected as expert participants for the Delphi panel. The Shannon entropy method was utilized for risk weighting, and the TOPSIS method was applied to rank the identified risks.
Results: Kendall's coordination coefficient was used to assess the level of consensus among the Delphi panel members, with the coefficient values for the first, second, and third Delphi rounds being 6.3, 7.1, and 7.3, respectively. The indicators were weighted using the Shannon entropy method, based on three criteria: impact intensity (0.3), probability of occurrence (0.4), and detection probability (0.32). The TOPSIS method was then employed to rank the identified risks, with the most significant risks being the need for necessary infrastructure (0.847), the requirement for accurate and complete data (0.751), and budget constraints (0.749).
Conclusion: By applying multi-criteria decision-making methods, healthcare managers can effectively identify and prioritize the risks associated with using AI systems in hospital waste management, enabling them to focus on strengthening waste management practices based on these priorities.
Seyed Masoud Mousavi, Sajjad Bahariniya, Aisa Mardani, Najmeh Baghian,
Volume 22, Issue 4 (1-2024)
Abstract
Background and Purpose: Organizational commitment among nurses, a critical aspect of hospital workforce management, is influenced by various factors, including job attachment. This attachment fosters motivation and commitment, which ultimately enhances the quality of healthcare services. This study investigates the relationship between organizational commitment and job attachment among nurses working in selected teaching hospitals affiliated with Shahid Sadoughi University of Medical Sciences in Yazd in 2022.
Methods: This descriptive-analytical study involved all nurses at Shahid Sadoughi Hospital in Yazd. A sample size of 298 nurses was determined using Cochran's formula. Data collection was conducted using the Job Descriptive Index (JDI) by Edwards and Kilpatrick (1984) and the Organizational Commitment Questionnaire (OCQ) by Allen and Meyer (1990). The data were analyzed using the Chi-square test with SPSS version 21 software and structural equation modeling via LISREL software.
Results: Among the nurses surveyed, 43.17% reported being satisfied with their jobs, while 40.17% exhibited organizational commitment. The findings revealed a significant relationship between job attachment and organizational commitment (P<0.001). The average scores were 3.75 ± 0.76 for the affective dimension, 3.97 ± 0.26 for the continuance dimension, 3.65 ± 0.36 for the normative dimension, and 3.74 ± 0.93 for overall job attachment.
Conclusion: The significant direct relationship between job satisfaction and organizational commitment highlights the importance of managerial focus on enhancing job satisfaction to increase employee responsibility and commitment. Managers should prioritize factors that improve job satisfaction as a means to strengthen organizational commitment.
Mehran Lak, Farnaz Vosough, Kianoush Saberi, Shahnaz Sharifi, Hadi Pashapour,
Volume 22, Issue 4 (1-2024)
Abstract
Background and Purpose: Infections related to inadequate healthcare practices can have adverse effects on healthcare systems. This study aims to identify the gap between the current handwashing practices and standard levels by determining the frequency of handwashing among staff at Shahid Modares Hospital in Tehran.
Methods: This descriptive cross-sectional study was conducted in the wards of Shahid Modares Hospital between 2018 and 2019. The tool comprised two parts: job information and hand hygiene practices at different times and specific actions. Observers directly monitored all staff in each shift using a headcount method. Each column represented the hand hygiene compliance score of a specific professional group, allowing simultaneous performance evaluation.
Results: Out of 640 observed instances, 202 involved the use of disinfectants, 255 involved handwashing, 111 involved glove use, and in 71 instances, hand hygiene was not observed. The highest compliance occurred when staff intended to contact the patient's body, while the lowest compliance was observed after performing surgery on the patient.
Conclusion: Given the significant role of nurses in therapeutic interventions, multifaceted training interventions, the drafting of hand hygiene policies, and increasing awareness among department officials should prioritize this group of employees. These measures aim to bring practices closer to desired standards and prevent unwanted consequences.
Mohammad Amin Zar Foroush, Zeinab Partovi Shayan, Ghasem Rajabi Vasakolaei,
Volume 23, Issue 1 (5-2024)
Abstract
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.
Jamil Sadeghifar, Nasim Eyvani, Ghasem Rajabi Vasukolai, Naser Farhamand Moghadam, Shahram Ekhtyari,
Volume 23, Issue 1 (5-2024)
Abstract
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.
Saied Moradi, Mohammadreza Rabiee Mandejin, Mohammad Mohammadi,
Volume 23, Issue 1 (5-2024)
Abstract
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.
Ebrahim Bahrami Nia, Reza Shams Allahi, Sedigheh Gholamrezaee, Mohamad Mehdi Zare Shahne,
Volume 23, Issue 1 (5-2024)
Abstract
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.
Roohollah Askari, Hassan Jafari, Arefeh Dehghani Tafti, Neda Futuhi Tafti,
Volume 23, Issue 1 (5-2024)
Abstract
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.
Seyed Mohammad Mahdi Heydari Baghdadabad, Alireza Maetoofi, Ali Farhadi Mahalli , Mojtaba Tabari,
Volume 23, Issue 2 (8-2024)
Abstract
Background and purpose: Hospitals play a critical role in promoting public health and well-being in social contexts. This necessitates codified standards aimed at maintaining treatment quality and enhancing social satisfaction. Hospital accreditation policy evaluation is considered a systematic process that can have significant social and functional implications for hospitals. This study aims to present an evaluation model of hospital accreditation policy based on the process of paradigmatic phenomenology.
Methods: Using Husserl's (1970) phenomenological approach, this study developed a paradigmatic evaluation model in five analytical steps. First, through interviews with experts and open coding, propositional themes related to the phenomenon under study were identified. A focus group was then formed to discuss and analyze these propositions. Each proposition was scored using the Q-method checklist, with scores ranging from +6 to -6, to identify paradigmatic clusters.
Results: During the qualitative analysis, 16 interviews resulted in 138 open codes. After eliminating redundancies and overlapping codes, 50 propositional themes were finalized. These themes were organized into conceptual clusters within the framework of paradigmatic phenomenology, following Husserl's methodological steps.
Conclusion: The study's findings underscore the formation of a hospital accreditation policy evaluation model structured around causal, intervening, contextual conditions, strategies, and outcomes. This model has the potential to enhance the effectiveness of healthcare service delivery and improve the overall quality of treatment in society.
Khatere Khanjankhani, Tina Seirafi, Sajjad Bahariniya, Atefeh Ebrahimi, Seyed Masood Mousavi,
Volume 23, Issue 2 (8-2024)
Abstract
Background and purpose: Medication errors, which are more commonly committed by nursing staff compared to other hospital personnel, can lead to severe and sometimes irreparable complications for patients. This study aimed to investigate the factors contributing to medication errors among nurses in selected hospitals affiliated with Shahid Sadoughi University of Medical Sciences, Yazd.
Methods: This descriptive-analytical cross-sectional study was conducted in 2021. A total of 302 nurses were selected from four teaching hospitals affiliated with Yazd University of Medical Sciences. Data were collected using a standardized questionnaire designed to examine medication errors across three domains: managerial, human, and environmental factors. Data analysis was performed using t-tests, ANOVA, and Pearson's correlation coefficient with SPSS version 26 software.
Results: Managerial factors emerged as the most significant contributors to medication errors. The leading causes of errors within the managerial, human, and environmental domains were: nurse shortages relative to patient numbers (mean ± SD: 4.34 ± 2.44), fatigue due to workload (4.17 ± 0.98), and high work density during shifts (6–12 hours), respectively. A statistically significant relationship was observed between environmental factors and gender (p=0.008)
Conclusion: Strategies to mitigate fatigue from workload, such as balancing nurses' shifts and increasing staffing levels, are recommended to enhance nurses' performance and reduce errors. Additionally, developing standardized protocols, implementing continuous monitoring of medication administration, and fostering a culture of teamwork are critical in minimizing medication errors.
Leila Vali, Hojat Farehmandnia, Ahmadreza Mohammadpour,
Volume 23, Issue 2 (8-2024)
Abstract
Background and purpose:
As people age, physical dysfunction often increases, leading to various challenges and a heightened need for urgent medical services. Elderly individuals are among the primary users of healthcare and pre-hospital emergency services. Their subjective experiences during emergencies are influenced by their need for timely and relevant information regarding emergency procedures and their clinical condition—a need that is also shared by their caregivers. This study aims to elucidate the experiences of elderly individuals who have used pre-hospital emergency services in Shiraz.
Methods:
This qualitative study was conducted in two phases. In Phase 1, semi-structured interviews were conducted with 21 elderly participants using purposeful and snowball sampling until data saturation was achieved. The interview transcripts were analyzed using Colaizzi’s method to extract key themes. In Phase 2, a panel of experts was convened to further discuss the findings and provide recommendations.
Results:
Analysis of the interviews revealed several themes related to the elderly’s experiences with pre-hospital emergency services. These themes were categorized into sub-themes including ambulance condition, performance of technicians, timeliness of emergency response, and issues related to emergency rules and regulations. In Phase 2, the expert panel offered practical solutions to address the identified challenges.
Conclusion:
The findings indicate that elderly patients face significant challenges when accessing pre-hospital emergency services, such as poor ambulance conditions, suboptimal technician performance, delayed emergency response times, and restrictive emergency protocols. The recommendations provided by the expert panel could inform policy development and lead to improvements in the quality of pre-hospital care for the elderly.
