Journal of

Background and Aim: A vast majority of clinical specimens are contaminated with Klebsiella species. The drug resistance among Klebsiella species is increasing day by day therefore, antibiotic senility test is necessary before prescribing antibiotics. The aim of this research was to determine the antibiotics resistance patterns of Klebsiella species isolated from clinical specimens of patients using the standard Kirby-Bauer method.

Materials and Methods: The present research was performed on 300 specimens of Klebsiella collected from Imam Khomeini hospital. After identification, drug resistance was investigated through the standard CLSI procedure. The drug sensitivity test was determined for all of the 12 antibiotics using standards of disk diffusion in agar Kirby-Bauer.

Results: The frequency rates of the isolated Klebsiella species were: pneumonia(94%), oxytoca(4%), ozaenae(1%), and rhinoscleromatis(1%). Moreover, in terms of source of infection, the collected samples in order of frequency were: urine, sputum, vagina, scar, stool, and blood, respectively. Altogether, the percentage rates of resistance were as follows: Ampicillin(97%), Amoxycillin(97%), Cefalotin(39%), Gentamicin(30%), Colistin(55%), Nalidixic acid(2%), Chloramphenicol(26%), Kanamycin(17%), Tetracycline(28%), Nitrofuration(44%), Ceftazidime(2%), and Amikacin(0%).

Conclusion: The results showed that the lowest resistance rate obtained was related to Amikacin in all tested Klebsiella therefore, it can be recommended as the most effective antibiotic.

Background and Aim: Regarding the importance of communicators' presence in health programs and the fact that in recent years, we have witnessed a decrease in their cooperation or a cut in their relationship with the headquarters. This qualitative study was performed to clarify communicators and instructors' administrative-recreational experiences in breaking off with the headquarters.

Materials and Methods: This qualitative study was carried out on 60 healthcare communicators, 20 ex- communicators and 35 instructors selected through purposive sampling. The data were collected using focus discussion groups and semi-structured interviews with the participants. For data analysis, qualitative content analysis was employed.

Results: The findings of data analysis revealed two main levels: recreational and administrative. The key themes of the former included medical facilities, gifts, employment, futurism and camp and of the latter consisted of credit resources, instructors' conditions, organizational posts and orientation.

Conclusion: Expressing what is expected from communicators when selecting them can play a significant role in keeping them up with their jobs. Holding meetings between authorities and communicators' representatives to discuss their problems and present solutions, holding reward ceremonies, preparing the grounds for attracting financial resources to support communicators' programs, appreciating them and enhancing the communicators and instructors' academic level, and creating organizational posts for instructors can be effective in maintaining their presence and enhancing health communicators' program.

 Background and Aim: Due to certain problems including being away from their families, entering a large and full-of-tension environment, and having economic problems caused by lack of sufficient income, students are likely to lose their mental health. This study is aimed to investigate college students' conditions and lifestyle at Tehran University of Medical Sciences (TUMS).

 Materials and Methods: In this cross-sectional study, 120 students from School of Allied Medicine were selected through simple sampling. Data collection tools included demographic questions and a lifestyle questionnaire. After collecting the questionnaires and coding the questions, the obtained data were analyzed through such statistical tests as t-test and ANOVA using SPSS software version 18.

 Results: Students' scores on lifestyle test were in the intermediate range and far from a desired situation. A two-sample t-tests did not show a significant relationship between students' lifestyle and their gender and marital status (P>0.05). Moreover, ANOVA test didn't show a significant relationship between students' age and educational level on the one hand and their lifestyle factor on the other.

 Conclusion: The results of the study revealed that students' lifestyle scores were in the intermediate range and that the situation was far from good. Standard educational programs and interventions should be designed to change students' lifestyle. Nutritional and physical support systems and educational, cultural, and entertainment programs in the department of physical education can minimize the concerns and preoccupations of the studied population group.

Background and Aim: In recent years, the family physician plan has been implemented as a main strategy of the health system in Iran. Therefore, the necessity to reform organizational structure based on new goals and strategies is felt more than before. The aim of this study is to review and summarize all cases about Iran’s organizational structure and its challenges in primary healthcare system.

Materials and Methods: This study is a systematic review. All relevant databases, bibliography of related papers, and laws were searched using appropriate search strategies and keywords. To evaluate the quality of selected papers, CASP tool was applied by two experts, and their choices were discussed to reach a final decision.

Results: Fourteen final cases were categorized in two groups: papers and upstream policies and laws. The results revealed the ineffectiveness of current organizational structure at different levels. The majority of the findings suggested proper reforms in the system. Centralization and delegation processes were the main dimensions studied.

Conclusion: Due to fundamental changes in goals and strategies, certain reforms in the organizational structure of health system in Iran are indispensable, especially at peripheral levels.

Key words: Primary Health Care System, Organizational Structure, Iran

Background and Aim: In recent years, the family physician plan has been implemented as a main strategy of the health system in Iran. Therefore, the necessity to reform organizational structure based on new goals and strategies is felt more than before. The aim of this study is to review and summarize all cases about Iran’s organizational structure and its challenges in primary healthcare system.

Materials and Methods: This study is a systematic review. All relevant databases, bibliography of related papers, and laws were searched using appropriate search strategies and keywords. To evaluate the quality of selected papers, CASP tool was applied by two experts, and their choices were discussed to reach a final decision.

Results: Fourteen final cases were categorized in two groups: papers and upstream policies and laws. The results revealed the ineffectiveness of current organizational structure at different levels. The majority of the findings suggested proper reforms in the system. Centralization and delegation processes were the main dimensions studied.

Conclusion: Due to fundamental changes in goals and strategies, certain reforms in the organizational structure of health system in Iran are indispensable, especially at peripheral levels.

Background and Aim: Nowadays, hospitals believe that applying the principles of management improve quality, and enhance competition and development. One of the ways to achieve these goals is the use of 5S. This study is aimed to determine and compare  supporting departments of Amir Alam Hospital before and after the implementation of 5S.

Materials and Methods: This descriptive analytical and cross-sectional study was conducted within three departments: Kitchen, laundry and the maintenance & repairs departments  of Amir Alam Hospital. Five checklists were designed for collecting information before and after the implementation of 5S within each department. Data analyses was performed using Wilcoxon test and SPSS version 19.

Results: Average rating after running 5S was more than before within the kitchen Section. However, there was a significant relationship before and after running 5S in only stage one and five. Within maintenance & repair and the Laundry departments, average rating after implementation of 5S was higher than using it before. In addition, all purposes with the exception of employees’ adornment, were statistically significant in all of five stages.

Conclusion: Implementation of 5S systems will contribute to increase in employees & patients’ efficiency and satisfaction, which in turn will lead to achieving higher productivity and economic growth. Therefore, we recommend other hospitals and departments to apply the concept of 5S.

Background and Aim: Safety is an important component in the quality of health care that lack of attention to it leads to harmful results. This study was conducted to estimate the safety management status in selected hospitals affiliated with Tehran University of Medical Sciences. 
Materials and Methods: This analytical-descriptive cross-sectional study was conducted in four selected hospitals affiliated to Tehran University of Medical Science in 2012. Data collection was performed through a valid and reliable questionnaire (Safety management) involved 112 questions in 3 parts: organization, safety and event committee’s management, investigation of organization and hospital’s structure and evaluation standards for surgery rooms by safety management views, in 5 options of Likert criteria. SPSS software frequency, mean and standard deviation and Kruskal–Wallis were used for statistical analysis of data’s.
Results: In the evaluation of the hospital organization factor and its structure from safety management approach, each hospital’s organizational structure form safety management view was in a suitable condition (72.50). The result also showed that in respect to evaluation of surgery rooms for safety management, the highest average of calculated score was for hospitals number 1 (90.00) and the lowest was related to hospital number 4 (69.09). 
Conclusion: According to the results, safety in hospital was in an acceptable level. But it seems that continuous monitoring and safety management training courses is essential.