Journal of

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Background and Aim: An Adapting work condition with physical and mental conditions of employees is an essential factor to do the job effectively. This study was conducted to determine the relationship between employees occupational accidents and absence from work in Shiraz Namazi Hospital. Materials and Methods: This descriptive-analytical and cross-sectional study was done in Shiraz Namazi Hospital at 2010. One Hundred and sixty employees in different departments of the hospital with a random stratified sampling were enrolled in this study. Data were collected using the checklist consisting of three parts: demographic information, types of occupational accidents and three open questions to enumerate other occupational accidents, diseases resulting from occupational accidents and possible causes of exposure to this accidents. Data were analyzed using the SPSS software and using descriptive statistics and chi square & t tests. Results: Out of 160, 159 participants responded and returned the questionnaire,out of which 68.9% were females. Cuts with sharp objects (22%) and toxicity resulting from working with solvents (82%) were the lowest and highest nonexposure in sample's studies, respectively. A statistically significant relationship between gender, work shift, organizational status and duration of employment with the occurrence of a number of occupational accidents was observed. Conclusion: According to the results, there was no clear relationship between absences from work and frequency of each occupational accident. We recommend the hospitals to consider notebooks for recording occupational accidents and theirway of occurrence. Also , training courses for employees shoud be in priority.

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Background and Aim: Work engagement is defined as a positive, fulfilling, work-related state of mind that is characterized by vigor, dedication, and absorption. Since the quality of care delivery to patients depends on nurse's practices, the objective of this study was to determine work engagement & its effective factors among nurses of general hospitals of Shiraz University of Medical Sciences.

Materials and Methods: This cross sectional study was performed among 273 in-patient nurses of Namazi and Faghihi hospitals using 2 stages of sampling. Our questionnaire was validated by experts opinions and Cronbach's alpha index (86%). Descriptive statistics and correlation tests were used for the analysis of data by SPSS.

Results: According to the results obtained, mean work engagement was 58.95 ± 10.51 and there was a significant correlation between work engagement and organizational - supervisor support, organizational justice, job characteristics, reward & recognition, organizational citizenship behavior, organizational commitment, job satisfaction, turnover( p<0.05). The relationship between work engagement and reward was the strongest(r=0.512).

Conclusion: The results imply the importance of work engagement and its related factors. Nurses are one of the biggest health system groups, and their burnout disadvantages hospitals and community. Thus, work engagement should be noticed in all policy-making related to nurses.

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Background and Aim: Assessment of hospital performance increases responsiveness and efficiency of limited resources. One of the most useful models of hospital performance assessment is Pabon-Lasso, a graphical model that determines the relative performance of hospitals using three indicators: Bed Occupancy Rate Bed Turnover and Average Length of Stay. The present study aims to compare the performance of Lorestan University of Medical Sciences (LUMS) hospitals using the above-mentioned tools.

Materials and Methods: In this descriptive cross-sectional study, fourteen LUMS hospitals were selected through census. The data-gathering instrument was the standard data form verified by the Ministry of Health and Medical Education. Bed Occupancy Rate, Average Length of Stay, and Bed Turnover Rate were calculated and Pabon-Lasso graph was drawn using SPSS 15.

Results: The average length of stay, bed occupancy, and bed turnover rates turned out to be 3/21 days, 53/07% and 95/54, respectively. Five hospitals were in Zone III, indicating a satisfactory level of efficiency. Four hospitals demonstrated inefficiency and underutilization of resources by falling into Zone I. Three hospitals were placed n Zone II. And two hospitals were in Zone IV.

Conclusion: Among 14 studied hospitals, just 5 were considered as efficient. Therefore, it is necessary that policy-makers develop solutions to improve the performance of other hospitals and distribute health resources appropriately.

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Background and Aim: The main purpose of all organizations is improving efficiency and effectiveness. One of the barriers of reaching effectiveness is burnout which can be seen as the final outcome of job stress in many professions including nursing. This study aimed to evaluate the correlation between effectiveness of nurses and burnout in Shiraz Nemazee hospital.

Materials and Methods: This descriptive-analytic and cross-sectional study was done among all of the nurses in the Shiraz Nemazee hospital. Two hundred and forty five nurses were selected using random classified sampling method. The data gathering form was standardized questionnaire. Data were entered into SPSS 15 software and the Pearson correlation test was used for data analysis.

Results: The study nurses were at moderate level according to burnout and effectiveness variables. There were positive correlation between “effectiveness” and “target acquisition” and “preservation of the cultural model” dimensions with “lack of individual success” dimension (P<0/05). Also, there was a negative correlation (P<0/05) between burnout in nurses and their effectiveness.

Conclusion: It seems that nurses’ burnout can affect their effective performance so managers can enhance effectiveness of staff performance by providing programs to reduce burnout and its dimensions.

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Background and Aim: Hospital complaining is an important dimension of clinical governance. This study aimed to determine the impact of clinical governance program on patients’ complaint in Shiraz public hospitals.

Materials and Methods: This applied study was conducted as descriptive-analytical in 2012 in Shiraz. The population studied was 10 public hospitals in Shiraz and the patients complaints were studied during 5 years. Data collected through Iranian Ministry of Health standard checklist of clinical governance. The data entered to SPSS version 21, and analyzed using descriptive statistics and analytical tests such as Chi-square.

Results: Registered complaints had increasing trend during the execution of the program  and were 1905. Moreover, 60.5% of the complaints have been made by family members. There was significant relationship between complaints registered with the hospital wards (P=0.000) and gender (P=0.000). Therefore, both genders and in all departments of the hospital complaints of poor quality and inappropriate behavior of the staffs was greater than other complaint.

Conclusion: The number of complaints has increased in recent years. It is proposed to reduce the number of complaints attention to improve  communication between physicians and patients, medical ethics, cut non-conventional financial relationaship between physicians and patients, and increased scientific and technical knowledge and skills.

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Background and Aim: The number of patients who leave hospital against medical advice could reflect patient dissatisfaction and it is a notable important problem. The present study aimed to identify the causes of discharge against medical advice at a hospital of Shiraz University of medical sciences.
Materials and Methods: This was a qualitative study using grounded theory. Data were collected through telephone interviews with patients or their concomitants. All interviews were recorded by researcher and thematic method used to analyze the data. Based on it, causes of discharge against medical advice were determined and solutions were provided.
Results: Causes of discharge against medical advice were categorized into 3 general themes: "causes related to the status of the hospital", "causes related to hospital staff", and "causes related to patients" that each of them include some sub-themes. Between the sub-themes, the issues relating to the hospital staff and economic status of patient had the most and the least frequency respectively.
Conclusion: The research findings make it possible for the hospital managers to find solutions to prevent creation of DAMAs and side effects for early discharged patients, patients' readmission and imposing additional costs on them. These solutions can be mentioned as attention and understanding of authorities, preparing some amenities for patients, holding justification meetings for medical personnel and students and reengineering some hospital processes.