Journal of

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.

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.