Journal of

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Background: Nowadays, health care section is one of the most important parts of sustained development in human societies because of having relationship with human health. Achieving this goal needs to have healthy and motivational staff, including nurses. We see nurses in all hospital wards who have been interested in their works when entering the hospital, but feel fatigue after several years and may give up their jobs. This survey has been conducted to study of effective factors on nurses' job motivation in Kerman University of Medical Sciences hospitals.

Material and Methods: This is a cross-sectional survey that studies 232 nurses occupied in Kerman university of medical sciences' hospital inpatient wards who were selected by stratified random sampling using a questionnaire which had 31 questions in 5 area: psychological, educational, financial, administrative and welfare factors. For determining the reliability of questionnaire, we conducted a pilot study and its _Krunbakh was 0.92. we used spss11.5 and Kruskal-Wallis and Mann-Whitney tests to analyze data.

Results: The results show the statistical relationships between welfare factor and hospital type (P=0.012), between psychological factor with sex, job experience and marital status (respectively, p=0/002, p=0/043 and p=0/011). But there weren't any statistical relationships between nurses' age and educational status and the studied area of motivation.

Conclusion: In this study, nurses who have following characteristics, have also better motivation status: occupying in hospital B, being married, being man, having master of science degree, having more than 10 years job experience and being between 30-40 years old.

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Background: Focusing on making opportunities to participate of patients in all levels of health care system is important in order to develop of system capability that could make improving of patients’ safety and quality of care services. The aim of this study was to determine inpatient perceptions in general hospitals of Tehran medical university regarding patient participate in treatment decisions and safety. Material and methods: This was a cross-sectional study in 1390. First, the list of eight general hospitals affiliated to Tehran University of medical sciences and all clinical wards were obtained through the university website. Then, stratified random sampling method applied to collect 300 patients as a sample size. Data were collected by using a structured questionnaire that validity and reliability were accepted. Descriptive statistical methods, linear regression and multivariate logistic regression were applied to analyze. Results: From total of 300 patients, 60% of them were female. The level of participating by patients in cure decision making were at high level (59.7%) and 27% in low level. The range of patients’ safety was at high (60%) and low (26%). The level of participate in decision making of cure process had high rate among young people and employed participants. The patients who were unmarried, educated, and employed had lower score in patients’ safety. The participants’ perception had no effect on the patients’ safety perceptions. Conclusion: The symptoms that might be interpreted as an abnormal could be interpreted in different ways by the others. These unusual results could come from dissimilarities in demographic features

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Background: Three aspects of health, responsiveness rate and equitable financing introduced as the main goals of health systems. In this study, responsiveness rate was assessed among private and social security hospitals in 2013.

Materials and Methods: The descriptive-analytical study conducted as a cross-sectional one among 10 hospitals in Tehran city (20 percent of total social security and private, 8:2 respectively) in 2013. Study population consisted of all inpatients and outpatients referee to eight private and two social security hospitals and 333 subjects selected to data gathering randomly. The valid and reliable World Health Survey questionnaire was utilized. Data was analyzed by SPSS₁₇ using descriptive statistic, Mann–Whitney and Kruskal–Wallis tests.

Results: In points of view among inpatient and outpatient, the mean score of responsiveness rate were 4.1±0.71 and 3.7±0.60 respectively. These amounts estimated 4.4±0.46 and 3.2±0.82 for inpatient and 3.8±0.58 and 3.5±0.63 for outpatient in private and social security hospitals respectively. Also, the mean score of responsibility rate assessed 4.4 in private hospital which was higher than social security ones (3.2); and this difference was statistically significant (P<0.001).

Conclusion: Responsiveness rate dimensions were evaluated moderate to high among assessed hospitals. These results were enhanced in private hospitals rather than social security ones. It is recommended that hospital managers should pay more attention to client and mechanisms to improve responsiveness rate and providing more services quality. 

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Background: Nowadays, Patient Safety is considered as a fundamental concept of the healthcare system. Hence, recognizing the effective factors such as illegible orders, dosage errors, and drug usage can reduce serious side effects leading to the patients' disability, prolonged hospitalization and even death.

Materials and Methods: This descriptive-analytical study performed as a cross-sectional one. 1800 inpatient records selected in a teaching hospital during one year. The physician  first order was examined through a self-adminstrated checklist including physicians’ ID and workshifts, and variables  like legibility and recorded dosage. Data analysis conducted via SPSS using descriptive statistics and analytical statistics tests.

Results: Among 1800  studied records, there were 66.3% recorded by male, 17.6% illegible, 3.2% with no  stamp, 8.2% without signing, 11.9% without time and 4.9% with no date.23% of physician records didn't have coherence and logical sequence, 69.5% did not indicate to the primary items, 17.8% with no medicine dosage, 21.8% without pharmaceutical forms, 11.5% with no usage time, 25.9% without usage method, 14.3% had scribbles and 13% were devoid of numbering.  Also, there were a significant relation between demographic variables and some medical recording errors. 

Conclusion: it is necessary to endeavor physicians in patient records documentation improvement and can be used some strategies such as educating the newly arrived residents, considering commendatory techniques and record periodic evaluation.

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  Abstract

  Background and Aim: Especially in the case of Hospital services, quality assesment is an complicated and vague issue. For achieving this goal Multiple Criteria Decision Making methods help us. These studies aims to knowledge and prioritize quality indicators and rank selected inpatient wards in an elected hospital of Tehran university of medical science by using Analytical Hierarchy Process and TOPSIS methods.

  Materials and Methods: This is a descriptive-analytical and cross-sectional research. At the first, with an overview of the research literature and expert opinion, indicators of quality assessment were selected. Then we did prioritization of these indicators with using of expert opinion and AHP method. In the final stage, selected inpatient wards the Hospital were ranked in terms of quality of service using TOPSIS by a sample consist of 300 of inpatients.

  Results: Eight main domains (Responsiveness, Safety and risk management, Tangibles, attention to patient, Health communications, Competency and professionalism, accessibility, Credit and assurance) were selected for quality assessment. Among these indicators, competency had the highest priority and attention to patient had the lowest priority. Also the department of Heart had the highest quality of service and the department of Neurology had the lowest quality.

  Conclusion: According to crucial role of the service quality on patients’ satisfaction, the use of appropriate indicators for quality of services, prioritizing them and also proper assessment of the quality of hospital services can play a major role in health policies.

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