Showing 52 results for Patient
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Volume 16, Issue 1 (4-2017)
Abstract
Background: The emergency department is as heart of hospital and is one of the first points of contact for patients with health care system are facing a variety of challenges. This study aimed to explore the challenges of emergency departments in teaching hospitals of Mashhad University of Medical Sciences.
Materials and Methods: This study was carried out through a qualitative approach and phenomenology method in 2013 in Mashhad, Iran. Twenty nurses and two emergency medicine specialists were recruited from four teaching hospitals in Mashhad Iran using purposive sampling. Data were collected through semi-structured in-depth interviews. Interviews were transcribed verbatim and analyzed using conventional content analysis approach according to colaizzi with MAXQDA 3 software.
Results: The results of this study indicated that challenges of emergency department lay in
Three main aspects including: "challenges in Human resources"(personal characteristics, professional characteristics and human resource limitations), "nurses' dissatisfaction"(less quality hospital hoteling and services for staff, disproportion between the workload and salaries, Lack of support from nurses) and " challenges in human resources management "(Structural challenges, the performance challenges and challenges in human resource management). Each theme included several category and subcategory that explain various aspects of the challenges in emergency department.
Conclusion: Human resource limitations, nurses' dissatisfaction and poor management were the most important challenges. Providing adequate human resources, support of nurses and determination guidelines and process for nursing care can reduce these challenges in hospital emergency departments.
Elham Haghshenas, Dr Mohammad Arab, Dr Abass Rahimi, Dr Elham Movahed,
Volume 16, Issue 2 (7-2017)
Abstract
Background: The quality of services is a comparison of the customer´s perspective (expectations) with what it has received. If the expectations are more than perceptions, the quality of received services is not sufficient based on customer´s view which resulted in his/her dissatisfaction. The present study performed with the purpose of determining the quality of provided and excepted services to outpatients among hospitals affiliated to Tehran University of Medical Sciences.
Material and Methods: The present study is a descriptive- analytics and cross sectional one which has been done in 2015. The study population included all outpatients attending hospital clinics affiliated to Tehran University of Medical Sciences.The sample size was calculated 225 participants based on formula. In order to data gathering in quality of provided and expected services, a 22-items standard questionnaire of Servqual was utilized. Data analysis performed by SPSS using paired t-test, Mann-Whitney and Kruskal-Wallis tests.
Results: The study findings represented that there was a negative gap in the quality of services provided. The highest gap was related to accountability (-0.97) and the lowest gap related to tangibles factors (-0.69) .Moreover, regarding to relationship between demographic variables with perceived service quality, there were significant relationship between insurance type with reliability and empathy dimensions and supplementary insurance with tangibles factors and reliability.
Conclusion: Negative gap (higher expectations than perception) in all aspects of quality improvement is required in all dimensions. Especially, it is necessary to adopt some strategies in the accountability dimension. Reforming management processes, reducing waiting times and increasing employees' motivation in order to achieve appropriate accountability are in this kind of strategies.
Dr Mohammad Arab, Serajadin Gray, Pejman Hamouzadeh, Farhad Habibi,
Volume 16, Issue 3 (11-2017)
Abstract
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.
Dr Peyvand Bastani, Mohammad Ghasem Nezhad , Ali Reza Yusefi, Dr Ahmad Sadeghi,
Volume 17, Issue 1 (5-2018)
Abstract
Background: One of the main components of the quality of health services is patient safety. This study aimed to determine safety culture status of psychiatric patients from the viewpoint of the medical staff of Ibn Sina and Hafez hospitals in Shiraz.
Materials and Methods: This descriptive-analytic study performed as a cross-sectional one in 2017. The study population included 165 health care personnel of the hospitals which were selected by census sampling. The study tool was a standard questionnaire for the hospital's safety culture. Data were analyzed using descriptive statistics and independent t-test, ANOVA, Pearson correlation coefficient and multivariate linear regression using SPSS version 23 software at a significant level of α = 5%.
Results: The average of safety status of the patients calculated 154.62 ± 19.74. The patient safety culture was estimated at an acceptable level (64.1%). The dimensions of personnel affairs (36%) and non-punitive responses to errors (34.7%) were in an unfavorable situation. There was a significant association between the employment status of personnel and patient safety (P<0.05).
Conclusion: Despite the acceptable condition of the patient's safety culture, however, the dimensions of the non-responsive response to the mistakes and issues related to the personnel were in an unfavorable situation and require prompt and appropriate actions. It is suggested that hospital authorities to provide the necessary interventions including cultures for reporting of errors, organizing comprehensive training programs, and continuously improving the clinical governance system.
Dr Ahmad Sadeghi, Dr Hossein Rohani, Sareh Davarzani, Zahra Davarzani,
Volume 17, Issue 2 (9-2018)
Abstract
Background: Patient complaints from the healthcare system can be helpful to respond patients’ needs using identifying the weaknesses. In this study, the complaints trend of patients has been investigated before and after healthcare system reform progress in a public hospital.
Materials and Methods: This descriptive-analytic study was carried out to assess trend of patient's complaints in two period of time in a northeast governmental hospital before and after healthcare system reform implementation (2012-2016). In order to collect data, the checklist designed by the ministry of Health was used. Data entered to SPSS version 21 and analyzed using descriptive statistics and analytical tests such as Chi-square.
Results: The study results revealed that the number of complaints were 29 and 198 before and after implementation of healthcare system reform, respectively. Most complaints were related to the emergency sector (31%) and about 40% of the complaints were from physicians. Most of the registered complaints were related to the quality of provided services (33.5%) and personnel exposure (30%), respectively. Accordance to study results, there was a significant difference between the number of complaints before and after implementation of the health system reform with the type of complainant (P <0.05).
Conclusion: Implementation of healthcare reform plan has led to systematic registration and special attention to complaints in assessed hospital. Most of registered complaints were related to the emergency department which requires managers and hospital officials to pay special attention to this sector and take effective steps to improve quality of services.
Parnian Nikmanesh, Dr Zahra Kavosi, Dr Ahmad Sadeghi, Ali Reza Yusefi,
Volume 17, Issue 2 (9-2018)
Abstract
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.
Mahdieh Tavakoli, Mohssen Ghanavatinejad, Fatemeh Jalalifar, Dr Elham Yavari,
Volume 17, Issue 4 (2-2019)
Abstract
Background: The admission unit is the main entrance of the hospital and the first patient communication with the hospital is through this unit. The waiting time of patients, which is one of the main consequent of this unit, is not only one of the important factors affecting the satisfaction of the patients, but also is one of indicators of the quality of service of the hospital. This study aimed to provide scenarios at reducing patients’ waiting times.
Materials and Methods: This research in terms of methods and goals was a descriptive and an applied one, respectively. This study performed on 110 patients who had been admitted to the Mohb-e-Mehr hospital during 70 days and were uniformly trained on all days of the week. Information was also obtained using observation and data recording in prepared forms. The simulation model was designed and implemented with the Arena 14 software.
Results: Based on research findings, the para-clinical unit and the waiting room for hospitalization were two main bottlenecks in the studied system. In order to solve the problem, for each of the above units, a scenario designed and simulated. The implementation of these tests revealed that the proposed scenarios in comparison with the existing conditions had better results in reducing the waiting time and also increasing the number of admitted patients.
Conclusion: Improvement of the therapeutic processes will occur through the recognition of the hospital services system and analysis of the bottlenecks and its weakness points. According to the results, an increase in the number of para-clinical unit staff and hospital beds improves the hospital admission function. The implementation of mentioned scenarios reduces waiting time for patients by about 78% and reduces the waiting time for emptying the bed by about 50%.
Dr Sodabeh Vatankhah, Ghasem Rajabi Vasokolaei, Dr Sogand Tourani, Samira Raoofi, Susan Rahimi,
Volume 17, Issue 4 (2-2019)
Abstract
Background: Development of the tourism sector and health tourism specifically can improve the Non-Oil GDP. In this regard, in accordance with the policies of the Ministry of Health and Medical Education, international patient department establishment has been facilitatated health tourism development in the affiliated hospitals. This study aimed to evaluate the performance of international patient department and its effect on the attraction of medical tourists among hospitals affiliated to Medical Sciences Universities in Tehran City.
Matrials and Methods: This analytical cross-sectional study was designed and conducted in 2017. Study population consisted of all hospitals affilliated to Tehran University of Medical Sciences (TUMS), Iran University of Medical Sciences (IUMS) and Shahid Beheshti University of Medical Sciences (SBMU). In this study, hospital entrance criteria was certified by the Health Tourism Department of MOHME. Data was collected using the health tourism assessment checklist which approved by the MOHME. SPSS version 24 utilized to data analysis using descriptive and Inferential statistics.
Results: The study results revealed that the overall performance of international patient department was evaluated at a desirable level (87.5 score) in hospitals of Tehran city. Hospitals had the highest rank of hoteling indices (95/100), in compliance with the regulations and functional indicators gained 87.03 and 82.2 score, respectively. Also, data analysis highlighted that there was no significant difference between hospitals of TUMS, IUMS and SBMU. The establishment of international patient department had no effect on health tourists attraction.
Conclusion: Considering the purpose and mission of international patient department to facilitate the provision of quality and satisfactory services in health tourists, management and oversight mechanisms for the standards implementation such as patient admission, follow up in the origin country and development of hospital marketing policies in order to attract international patients and increase hospital incomes are recommended.
Ali Reza Yusefi, Zahra Ebrahim, Behjat Mohammadzadeh, Dr Peivand Bastani,
Volume 17, Issue 4 (2-2019)
Abstract
Background: Brand loyalty is one of the most important factors in maintaining and success of huge organizations such as hospitals. This study aimed to survey the factors that affect the patients’ loyalty to hospital brands in teaching hospitals affiliated to Shiraz University of Medical Sciences (SUMS).
Materials and Methods: This cross-sectional descriptive-analytic study conducted in 2017. The study population consisted of 385 clearance patients who were admitted to educational hospitals in Shiraz using stratified sampling method in February 2017 to March 2018. Information was collected using a researcher-made questionnaire and data analyzed by descriptive statistics, T-test, ANOVA, and multiple regressions using SPSS version 23 at a significant level of α = 5%.
Results: Patients’ satisfaction (β=0.333, P<0.001), trust in brand (β=0.265, P=0.007), and commitment (β=0.181, P=0.011) had a direct and positive effect on the patients’ loyalty to the hospital brand.
Conclusion: According to this study results, hospital managers should pay an attempt to inform the patients about their treatment procedure, follow up the patients’ health after discharge, and increase the communication between personnel and patients. These could contribute to better image and experience for patients resulting in loyalty to the hospital brand.
Mohssen Ghanavatinejad, Mahdieh Tavakoli, Dr Mohamadmehdi Sepehri,
Volume 18, Issue 3 (10-2019)
Abstract
Background: with increasing demand for treatment, patients are monitored with help of Internet of Things(IOT). Patient's monitoring devices and technologies include heart rate measurement, blood pressure measurement, blood glucose and other vital signs. The purpose of study is to provide a model of clustering patient physical monitoring gadgets and apps in Healthcare Internet of Things (HIOT) environment using data mining techniques, so based on the needs and characteristics of the user, the more appropriate results of choosing technologies acquired.
Materials and methods: This study is a review and functional since its result. The data includes 6 unique features of 60 selected technologies including function, price, connectivity route, power supply, location and type of use that has been extracted from R&D and advertising sites of technologies and also relevant articles. data analysis method is clustering technique and K-medoids algorithm. to identify the most effective features, random forest algorithm has been used.
Results: the proposed clustering model takes into account 6 as inputs and clusters gadgets and apps in accordance with selected characteristics as the model outputs. clustering problem data is clustered in 4 categories. Silhouette index is 0.45, which indicates the validity of the model. The type of application and then the price had the greatest impact on clustering.
Conclusion: By this model, patients or users can find the most appropriate technology based on the type of disease and other effective features, such as price. So with accurate physical and momentary monitoring, disease progression decrease and prevention of disease will improve.
Seyed Mostafa Kohestani, Dr Hojjat Rahmani, Dr Sheyda Nourbakhsh, Dr Farhad Habibi, Ghasem Rajabi Vasoukolaei,
Volume 18, Issue 3 (10-2019)
Abstract
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.
Conclusion: Designing The Related Interventions To Control Nosocomial Infections, Making Hospital Managers And Staff To Sensitive In Nis Control, Holding Specialized Training Programs, Considering Basic Design Of The Physical Structure Of Hospital Wards, Considering Attitudinal And Motivational Are The Most Effective Ways To Combat Nosocomial Infections.
Dr Faramarz Pourasghar, Nesa Kavakebi,
Volume 18, Issue 4 (1-2020)
Abstract
Background: Information technology application in health care is increasing. The aim of this study, is to introduce a scientific model for designing an electronic system for managing patient transfer.
Materials and Methods: This study is an exploratory qualitative study. At first a review of literature was carried out for identifying clinical, managerial and process indicators necessary for patient transfer. Then 30 experts, who had vast experiences on patient transfer, were selected using purposive sampling approach and their informational needs were extracted using focus group discussion and semi-structured interviews. Then clinical indicators extracted from literature review and informational needs collected from interviews were distributed among 51 experts in the form of Delphi questionnaires. Process indicators were also distributed among 35 experts to summarize all necessary indicators for designing patient transfer system. At the final step an expert panel approved the model.
Results: Thirty eight process indicators and 249 clinical and managerial components were finalized for designing the system. The process indicators were used for designing “monitoring and reports sections” of the system. The clinical indicators were used for designing “main sections” of the system including request for patient transfer, automatic algorithm for selecting destination hospital, information flow cycle, communicating clinical data and documentation. Final model also includes user interfaces relevant to responsibility of the user.
Conclusion: The proposed model, which contains necessary indicators for patient transfer, can communicate clinical information among hospitals and by providing proper infrastructure, will be able to improve patient transfer process.
Nader Markazi Moghadam, Sanaz Zargar, Zaniar Ghaderi, Ehsan Tofighi,
Volume 19, Issue 1 (4-2020)
Abstract
Background: Hospitals play a key role in ensuring community health. Among the hospital departments, the surgery room accounts for a significant portion of the cost and revenue of the hospital. Surgery timing is important to increase the efficiency of operating rooms. The purpose of this study was to optimize surgical hall scheduling based on discrete event simulation model.
Materials & Methods: This cross-sectional study was performed in the summer of 2018 in the operation room of one of the hospitals in Tehran. As people entered the operation room, their information about the cause and condition that caused the surgery, the type of surgery (elective or emergency) the time of being in the operation was recorded by details. Data analysis was performed SPSS software and simulation of therapeutic system was performed Arena software.
Results: By analyzing the input data of 625 patients during three months, more than 60% of patients were men and less than 40% were women. The first entry into the surgery room for the selected patients was at 7:10 am and the last was at 5:00 pm. Of the eight scenarios presented, two arrival rate correction scenarios (noon arrival distribution) and a combined scenario (noon queue correction and patient adding) resulted in the greatest reduction in waiting time.
Conclusion: The results of this study showed that changing the distribution of patients 'arrival to hours with less input time can decrease patients' waiting time and increase the efficiency of surgery room.
Ali Mohammad Mosadeghrad, Fatemeh Khalaj,
Volume 19, Issue 1 (4-2020)
Abstract
Background and purpose: Electrocautery is a very important tool in surgery. Electrocautery burn is a common side effect of operation surgeries. Quality management is a useful strategy for improving the quality and safety of hospital services. The objective of this study was to examine the impact of quality management on reducing electrocautery burns.
Materials and methods: A participatory action research was conducted in the operating theatre of a hospital in Tehran, Iran, in 2013 and 2014. A quality improvement team was established in the hospital operating theatre. The quality improvement team using an 8-step quality management model, standardized working processes, identified quality goals for the processes and improved them until achieved the quality goals. Data on electrocautery burns was collected before and after the intervention and compared.
Results: Electrocautery burn rate was 0.40% in 2012. A wet patient due to sweating or washing during the surgery, in-appropriate patient position, faulty earth well, faulty anti-static mattress and long usage of electrocautery devices were the main reasons of electrocautery burn injuries. Accordingly an action plan was developed and implemented for preventing and reducing electrocautery burns. Consequently, electrocautery burn rate was reduced to 0.21% and 0.02% in 2013 and 2014. Electrocautery burn was significantly reduced by 95% in two years.
Conclusion: Electrocautery burns can be easily prevented using the quality management strategy. Implementing an appropriate quality management model appropriately in a supportive environment enhances the safety of hospital services.
Fatemeh Khazaei, Hasan Mirza Hosseini, Mostafa Nokani,
Volume 19, Issue 2 (8-2020)
Abstract
Introduction: Hemodialysis is one of the effective therapies in patients with chronic renal failure. Along with increasing life expectancy as a benefit of this treatment; this type of service can threaten the quality of life of recipients. Therefore, the present study was conducted to investigate the effectiveness of emotional schema-based therapy on improving the quality of life of dialysis patients.
Materials and Methods: The current semi-experimental, applied study was designed and implemented as pretest-posttest research with a control group. All outpatients treated with dialysis instrument in medical centres affiliated to Tehran University of Medical Sciences in 2009-2010 were the statistical population of the study and the quality of life questionnaire related to kidney patients used for data collection. After the research team performed the treatment protocol in 8 sessions of 90 minutes in the intervention group, the research data were analyzed using SPSS24.
Results: The results of the study showed that the treatment protocol based on emotional schema therapy influence all aspects of quality of life and increase the mean score compared to the pretest. Also, there is a significant difference between the groups, both in the general dimension and specific dimension of dialysis patient's quality of life.
Conclusion: As the study findings show, it can be stated that emotional schema therapy is effective in improving the quality of life of dialysis patients and can be used as a useful intervention to improve the quality of life of patients.
Seyyed Mohammad Mehdi Baki Hashemi,
Volume 21, Issue 1 (5-2022)
Abstract
Background: thousands of people die or suffer from irreversible damage due to lack of timely and adequate services in medical centers. This research seeks to identify and prioritize factors affecting the demand for patient transfer and provide the most effective measures to facilitate this process.
Materials and Methods: This research is combined in terms of method and inductive research in terms of type of research. The population of study is the senior and middle managers of Guilan University of Medical Sciences who were selected as a sample member using purposive sampling method. The factors affecting patient transfer demand were identified using qualitative data obtained from exploratory studies, then these factors were prioritized using fuzzy Delphi method.
Results: In the first part, a set of factors affecting the demand for patient transfer were identified, and in the second part, the importance and priority of these factors were determined. The results of the research showed fourteen main factors, including disproportionate distribution of specialized human resources, ineffective planning, inefficient management, and inefficiency of human resources.
Conclusion: Inefficient organizational processes and organizational structures along with real needs have been identified as reasons for patient transfer demand,which requires special attention of supervisors and management of organizational development and administrative transformation of universities. It seems that the formation of a special monitoring and planning working group to remove obstacles in a centralized manner at the highest organizational level and a special look at the reports of the care monitoring center as the most effective measure can be used to manage the dispatch process, planning, Monitor and remove obstacles.
Raziyeh Montazeralfaraj, Sajjad Bahariniya, Sara Jambarsang, Fatemeh Sadat Hashemi,
Volume 21, Issue 4 (1-2023)
Abstract
Introduction and purpose: The main mission of hospitals is to provide quality services for patients. Evaluating the quality of hospital services can lead to the targeted allocation of financial resources to areas that are in worse situation. The aim of the present study was to investigate the quality of services of university hospitals in Yazd province.
Methods: This cross-sectional analytical study was conducted in 2020-2021 in 12 university hospitals of Yazd province. In order to conduct the study, the standard questionnaire of SERVQUAL was used. This questionnaire is made up of two parts, administration and expectations, and each of them contains 28 questions and 6 dimensions. The sampling method was stratified randomly. Data analysis was done in SPSS version 24 software.
Results: 225 patients participated in the study. The majority of patients were over 50 years old (46.7%). The average score of patients' expectations (128.99±8.12) at the high level, the average score of patients' perceptions (107.98±8.62) at the middle level, and the average score of the total quality of hospital services (236.97±12.24) at the high level reported. In both areas of perceptions and expectations, the dimensions of reliability, responsiveness and assurance had a higher mean score and the physical or tangible dimensions, empathy and access had a lower mean score.
Conclusion: The service quality of university hospitals in Yazd province was in a good condition, but the average score of perceptions was lower than the score of expectations. Although there was no deep gap, it is necessary for hospital managers to pay more attention to improving the quality of services.
Seyed Mohammad Mehdi Baki Hashemi,
Volume 22, Issue 1 (5-2023)
Abstract
Background and purpose: Inter-hospital transfer refers to the transfer of patients to receive diagnostic, therapeutic and paraclinical services that can prevent more injuries or more effective treatment. The present study was designed with the aim of collecting and analyzing information related to sent patients and identifying the factors that cause the transfer of patients.
Methods: This cross-sectional study was conducted on 11,362 patient referral forms registered at Gilan University of Medical Sciences. Data were analyzed by Spss statistical software version 22 and Chisquer statistical test.
Results: The amount of patient transfer requests in 1401 compared to 1400 has increased by 9%. There is a relationship between the demand for transfer of patients with inappropriate distribution of specialized human resources, lack of demand feedback mechanisms, ineffective planning of nursing staff and residency of doctors in the hospital of origin, inefficient management of resources and equipment, lack of diagnostic, medical and pharmaceutical facilities, as well as with the seasons of the year. There is significant (p>0.05). There is a significant relationship between non-acceptance of patients and the lack or lack of beds needed by the patient in the destination hospital (p<0.05).
Conclusion: Improper distribution of specialized manpower according to the needs of the region, ineffective planning of resident guards, inefficient management have been identified as the main reasons for the demand for patient transfer. Forming a special working group to identify, evaluate, plan and monitor the removal of obstacles in a centralized manner and forming quality improvement circles can be a solution.
Hasan Fatahi, Seyyed Mohammad Waziri, Mahyar Souri, Mohammad Hossein Askarian,
Volume 22, Issue 2 (9-2023)
Abstract
Background and purpose: The emergency department of a hospital is akin to its heart, where smooth operations can save many lives. This research aims to reduce patient waiting time in the emergency department using simulation techniques.
Methods: This descriptive-analytical study was conducted cross-sectionally in 2019 at the Qaim Hospital in Mashhad. The study focused on accurately modeling the patient flow process in the emergency department using simulation techniques and Arena software. Key performance indicators such as patient waiting time, number of discharged patients (system output), length of stay, resource efficiency, and improvements in the emergency department were evaluated.
Results: The simulation model's results indicated that the laboratory, specialist doctor examination, and pharmacy departments had the longest waiting times in this department, respectively.
Conclusion: To reduce patient waiting times and improve conditions, the most effective and cost-efficient solution is to add a laboratory technician to the laboratory department during the [15-23] shift at Qaim Hospital in Mashhad, which is projected to decrease patient waiting times by 66 minutes.
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.
