Journal of

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Introduction: Evaluations of a system of information, without analyzing its users understand is impossible. User satisfaction is as key factor of success information system. It is essential to consider information system context (user, task, equipment and environment), user type and user experience in quality ergonomic computerized information systems. Therefore in this study HIS quality ergonomic of Iran compared with other software.

Methods: A comparative study in 1389 was conducted. In order to compare the evaluation results of hospital information system with other software, applications were selected that already were evaluated using isometric questionnaire. These software are a) IS-H * med (software evaluated by Hamburg and colleagues in 2004), b) SAP-HR (software evaluated by Gruber 2000) and c) Microsoft word for Windows (software evaluated by Gediga and colleagues in 1999). Users view analyzed through descriptive statistical and one sample t-test. Data analyzed through SPSS and Excel.

Results: HIS than IS-H * med of is significantly more usable. HIS than SAP-HR in terms of the IsoMetric Scales such as "suitable for task," "suitable for learning", "Error tolerance" and "learning ability" is significantly more usable. HIS vs. Microsoft's word is significantly less usable.

Conclusion: The results of this study showed that hospital information system in Iran than the other software studied is average level in terms of ergonomic software quality. It is recommended regarding user expectations when designing and developing of information systems.

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Background: Medical tourism is an increasing industry that patients travel to abroad for receiving health care services. The countries which are successful in this industry have global accrediting quality. This research is aimed to access capabilities of selected hospitals in Iran University of Medical Sciences in attracting medical tourists according to JCI patient-oriented standards. 

Materials & Methods: This research is a descriptive, cross-sectional study that carried out in Hasheminejad, Rajaie and Motahhari hospitals. To collect data patient-oriented checklist of JCI standard used. Data analyzed by using descriptive statistic techniques.

Results: The results showed the high rates of consideration is related to medication  manage­­ment and standards used (84/5%), and anesthesia and surgical care standards (80%) that both of them are related to Hashemi­­nejad hospital and also patient and family rights standards (47/5%) are low rates of considerations that are related to Motahhari hospital. Generally, the mean rates of consideration in Hasheminejad (71/8%) are more than Rajaie hospital (67%) and these hospitals are more than Motahhari hospital (62/3%).

Conclusion: Generally, the selected hospitals had rather readiness and possible and appropriate capabilities in attracting medical tourists. Some standards (access to care and continuity of care, patient and family education, assessment of patients, anesthesia and surgical care) were appropriate and some of them were insufficient (patient and family rights, care of patients and patient and family education). According to identify strengths and weaknesses of the hospitals in medical tourism, they could use SWOT analytical model to increase their capabilities.

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Background: Hospital is the most expensive part of a health system. Manpower is the mainly valuable factor in productivity and service delivery. Since personnel costs make up more than 60% of hospital costs, increasing productivity and efficiency of human resources are significant. The most important ways to increase utilization of this valuable resource is to standardize the quantity and composition of the human distribution. This study determined the standardizing of nurses resources in a sample hospital.

Materials & Methods: The descriptive and cross-sectional study applied in 2008. Data of study collected by questionnaires and library studies by using descriptive statistics were analyzed. Sample of study is the private general hospital with 85 active beds, including gynecology, surgery, men and children, women, surgery, neonatal intensive care wards. Data collection tools were tables containing the number and composition of nurses and hospital performance indicators. After gathering data, it compared with the standards and recommendations were conducted. Using standard of job hours of nursing care required for each group of patients and protocols of Ministry of Health and Medical Education.

Findings: The numbers of nursing staff in the hospital were 96 people, including 38 nurses, 16 assistance nurses and 42 aid nurses. The optimum numbers based on average annual bed occupancy in different sectors were: 94 nurses, including 60 nurses, 34 assistance nurses and aid nurses.

Conclusion: A sample hospital uses healthcare workers as an aid nurses to assist in a wide range of patients' care. With regard to development of medical sciences and become more specialized nursing care industry and major changes in techniques and equipments, to move on from traditional invasive surgical procedures to non-invasive medical practices and the incidence of further complex cases, it will be effected to replace them with educated nurses to care of patients.

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Background: Medical diagnostic laboratories play an important role in diagnosis, treatment and prevention of the diseases. Today’s without assisting of the laboratories, conserving of public health and outbreaks prevention of infectious and genetic diseases is impossible. In this research the cases determined by the department of health and medical education questionnaire in quality control of public and private laboratories. Materials and Methods: This study is a cross sectional (descriptive and analytic) in which 20 private medical diagnostic laboratories and 16 training centers were selected. The quality control standards were reviewed and compared. Results: From 12 items of the questionnaire the two following items, rules and regulations in both private and public laboratories gained the highest priorities with 100% private and 93% governmental laboratories respectively. The lowest score was related to testing quality control of the laboratories with that of public and private ones, 82% and 75.7 percent respectively. In all that cases, governmental laboratories and training centers were rated lower than private labs. Conclusion: This study showed that both private and public laboratories’ score were under below of standards. Governmental laboratories were rated lower than private labs. In private laboratories, identifying errors and in the governmental laboratories, testing quality control should be considered

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Background: The existed difference statistical indicators is necessary to measure the efficiency of the health organization and as an exact strategy, could be removed the developed problems in heath services sectors. Materials and methods: This is a descriptive research as a cross sectional study throughout obstetric and gynecology wards in the general hospital of RASOOL. The questionnaires and statistical Forms applied for data gathering. The methods were completed questionnaires, statistical Forms, face to face interviews and observation. The Delphi technique, standardized questionnaires and references’ text books used to determining the reliability and validity. Data analysis was done by using likret ranking. results: The results showed that some indicators, such as inpatient bed occupied rate (63%), bed turnover interval(5) & mean length of stay(4), patient per nurse(19), meanwhile service education(10),staff per active bed(1for 12), midwife per delivery bed(0), staff(50.9%) and patient satisfaction(89%) were lower than expected. Some indicators such as rooming in technique(100%), breast feeding(100%), patient information access from HIS system(100%), emergency and hostelling medicine access(100%), round and morning reports(100%), the mean admitted time in the ward(30 minutes), Infant and maternal mortality rate per total deliveries(0), and the percentage of trained patient(100%) were as expected. Some indicators such as expert physician per active bed (1 for 7) and C/S per total delivery ratio (69%) which was higher than expected, and the necessary data for calculating book & papers per assistant professor & non colonial infection rate were not found. Conclusion: Hospital indicators showed the performance of hospitals in the various bases. Therefore,the broad attentions to these indicators are necessary. Meanwhile, it should be compared them and to distinct time periods.

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Background: Accreditation is one of the evaluation systems which have numerous effects on the key indicators in health care system. To develop a suitable accreditation model, a best way could be the benchmark of the powerful and successful accreditation models in all over the world. By considering likely differences in the various countries health systems, this study aims to survey the compatibility of the best accreditation models and standards in Islamic Republic of Iran's health care system.
Materials & Methods: In this study, the expert's perspectives have been ascertained about standards of selected references accreditation models based on standards "importance" and "feasibility" using two rounds Delphi Technique. The experts selected among scientific and academic experts in the areas of accreditation and health services management. They were asked to fill up the Delphi questionnaire and send back it to the researchers in the designated time. Each standard scored in Likert scale from 1 to 9. Standards with mean score of ≤ 3 were rejected, standards with mean score between 4 and 6 send to the second round and standards with mean score ≥ 7 included in the national model.
Results: In the first round, 20 out of 27 questionnaires have been obtained from experts. After data analyses all the standards have been accepted except 31 with mean score between 4 and 6. Remained 31 standards with achieved mean scores in first round, send back to the study experts through the second round. In the second round, 17 out of 20 questionnaires collected and finally 18 standards were rejected.
Conclusion: According to the variety of standards, comprehensive categories and richness of necessary details of standards, the resulted model in this study could be a rich and suitable model for Islamic Republic of Iran. Therefore, using this model could empower evaluation system and improve the quality of health care system.

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Background: nutrition department is one of the most important sectors of hospital to improve the patients' health and satisfaction. Lack of standards obsevance causes nosocomial infections and develops health risks. Establishing HACCP standards, many existing shortcomings will be omitted in the hospital nutrition department. This study aimed at assessing the mentioned nutritional standards system in the hospital nutrition department.

Materials and Methods:  This cross - departmental study was conducted at Kermanshah University of Medical Sciences' teaching hospitals in 2013. HACCP questionnaire was used. Data collection performed using observation, interviews and questionnaire filling in from hospitals' nutrition department.5-point likert scale used which rating scale was from 1(lowest) to 5(highest).in order to data entry and analysis SPSS software version 18 utilized using tables, graphs and Kruskal-Wallis test.

Results:  The mean score and percentage of five areas of HACCP standards were 3.58 and 70.23% respectively which were desirable in seven studied hospitals. There was no significant statistical relation between the mean scores of hospitals in the standards.

Conclusion: Although, the situation was assessed desirable, because of the importance of nutrition department, observance of optimum standards and quality improvement can prevent potential infections in food preparation and distribution and result in patients and staff satisfaction.

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Background: providing human resources is one of the most important factors to achieve the organization goals. Human resources are the most valuable aspect in production and service delivery. Staff shortages and excesses can be effective in reducing quality of services.This study aimed at assessing the hospitals' human resources condition from 2001 to 2014.

Materials and Methods: This review article extracted required information from ISI, Pubmed, Scopus, Wiley, Proquest, Emerald, Magiran, SID ,Iranmedex, Google, Google scholar and other related database considering keywords Human resource, Human resource management, Staff, Workforce, Hospital ,Iran, staff nursing, medical, physician personnel with Persian equation.  Searched Articles Search Based on article objectives analyzed step to step with arrangement with study title, abstract and full text.

Results: Findings revealed that the majority of hospitals faced to lack and inappropriate distribution of human resources especially in medicine and nursing but there was no shortage in logistic, financial, paramedics and allied professional human resources.

Conclusions: Correct and appropriate human resources management, planning due to compensated inadequate human resources and raising them to a standard level can enhance the efficiency and effectiveness of hospital activities. 

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Background: Considering the importance of standard precautions to prevent needle stick injuries and health care staff, this study aimed to determine the effectiveness of educational interventions to improve adherence to standard precautions, health belief model based on professional clinical staff needle stick two hospital "yaftabad" and "Ghiyasi" done.

Materials and Methods: This study was an experimental study of two group. The study population was 90 persons of professional clinical staff Shohada Hospital Yaftabad as the intervention group and 90 patients from the hospital Ghiyasi as compared to randomly selected and three part questionnaire including demographic, structures, health belief model , and practice questions were completed. In analyzing the data, descriptive and inferential statistical methods were used.

Results: At baseline, the two groups regarding demographic variables, health belief model structures and functional do not different between them. After intervention structures perceived severity, perceived susceptibility, perceived barriers, self-efficacy and performance of the experimental group showed statistically significant change (p< 0.05) that the effect of education based on health belief model.

Conclusion: education based on health belief model, you can increase the level of knowledge and capacity building and efficacy in clinical staff needs people to observe standard precautions

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Background: The Health Promoting Hospitals (HPH) initiative emphasizes on changes in traditional hospitals’ approach in care provision. This study aimed to provide scientific evidence required for successful planning and implementation of the HPH in the country’s educational hospitals.
 
Materials and Methods: In this descriptive-analytical study, opinions of 300 frontline health professionals working in the ten educational hospitals affiliated to the Tabriz University of Medical Sciences were examined using validated tools in 2016. Descriptive data analysis procedures and logistic regression analysis (using Enter method) were applied by SPSS software version 22. The level of significance was considered less than 0.05.
 
Results: The mean scores and SD for applicability of the HPH standards were 66.06±17.51. Gender (OR=3.19 95%CI: 1.33- 8.40), occupation type (OR= 1.50 95% CI: 0.65- 0.70), hospital type (general vs. specialized) (OR= 1.59 95%CI: 1.10- 1.25), number of active beds (OR=3.84 95% CI: 1.56-9.42) and having prior knowledge about the HPH program (OR=2.81 95% CI: 1.31-4.80) were identified as significant predictors of the HPH standards’ feasibility in the studied hospitals.
 
Conclusion: Given that study findings, at least the baseline subjective inclination to adapt the HPH standards in the educational hospitals do not exist through the Iranian health care providers’ points of view. As the first step in progress towards preparation for implementing the HPH standards, planning of tailor-made educational programs for hospitals’ staff in Iran is recommended.
 

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Introduction: The operating room is one of the most sophisticated workplaces, consisting of a vast array of electrical, gas and radiation equipment that are more susceptible to accident than other hospital departments. Therefore it is important to observe safety tips in this section. The purpose of this study was to evaluate the standard of safety in operating rooms of hospitals affiliated to Mazandaran University of Medical Sciences in 2019.
Method: This study was a descriptive cross-sectional study. The statistical population consisted of all operating rooms of hospitals affiliated to Mazandaran University of Medical Sciences. The tool used was a checklist that was completed by researchers by observation and interviewing on-site. Safety standards have been evaluated in terms of the physical space of the operating room, fire safety, personnel safety, patient safety, infection control. Data were analyzed by SPSS version 21.
Results: The operating rooms of university-affiliated hospitals were 80.10% secure in overall safety. The patient's safety area, with 83.34%, had the shortest distance from the standards and the infection control safety area, with 74.24%, had the highest distance from the standards. The highest and lowest scores were related to the safety standard related to the operating room of hospitals (2) and (1).
Conclusion: According to the findings, the operating rooms of the studied hospitals are generally in desirable compliance with safety standards. However, it is essential to pay attention to problem areas to increase the safety factor for staff and patients in the operating room, so appropriate remedial measures should be taken to ensure complete safety of the operating room for all components.

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Introduction: After the increase in the incidence and global spread of Covid-19 virus, medical centers faced a number of problems and challenges following this crisis. In order to increase the quality and safety of medical services and their optimal management, both in critical and non-critical situations, health care providers in different countries of the world have used various methods that increase the organizational commitment to improve quality.
Method: This study is a cross-sectional analytical research. Data were collected through a researcher-made questionnaire based on 903 accreditation standards notified by the Ministry of Health by available sampling method from 326 employees of Masih Daneshvari Center in 2021. Data were analyzed using SPSS software version 22.
Results: The results showed that out of an average of 8 areas related to accreditation standards, participants in the areas of professional ethics and compliance with the recipient of services, infection control, environmental health and waste management mentioned the most compliance in the emergency situation caused by Covid-19 and areas of clinical management and patient safety were ranked next.
Discussion and conclusion: According to the participants, observing the areas of environmental health and waste, service recipients and infection control has been more practical during Corona pandemic. The principles of accreditation seem to be accepted as quality improvement standards and can be an effective guide in preparing medical centers for emergency conditions.

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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.