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Omid Zadi Akhuleh, Abbas Dadashzadeh, Aysan Judi,
Volume 16, Issue 5 (12-2022)
Volume 16, Issue 5 (12-2022)
Abstract
Background and Aim: Surgical smoke (SS), is caused by the use of high temperature devices such as electrocautery, laser and ultrasonic scalpel, which are used for cutting and coagulation of tissue during surgery, is considered as a serious threat to the health of operating room (OR) personnel. Various studies have identified the workplace safety climate as one of the main causes of the occurrence or prevention of occupational hazards. This study was conducted with the aim of Perceived Safety Climate (PSC) in ORs and its relationship with the awareness of the OR staff about the SS hazards.
Materials and Methods: This cross-sectional study was conducted from April 2021 to July 2022 in the ORs of 26 public hospitals affiliated to Tabriz University of Medical Sciences. In this research, 396 surgical and anesthesia technologists were included in the study by stratified random sampling. Data were collected using a demographic questionnaire, PSC questionnaire and awareness about the hazards of SS questionnaire and analyzed using SPSS software
Results: The knowledge of the OR staff regarding the hazards of surgical smoke was evaluated at a moderate level with a mean and standard deviation of 9.82±4.32 (range 0 to 21). The average knowledge score of surgical technologists (11.1±4.56) regarding the hazards of surgical smoke was significantly higher than the average score of anesthesia technologists (8.75±4.1)(P=0.02). The PSC in the OR was evaluated at moderate level with a mean and standard deviation of 62.15±11.1 (range 19 to 95). The results of linear regression analysis showed that the effect of PSC in increasing the awareness of OR staff about the hazards of SS was significant (P=0.001). By increasing one score to the total score of the PSC, the awareness score increases by 0.201.
Conclusion: The safety climate of the OR can predict the awareness of the hazards of SS among OR staff. It is recommended to adopt strategies such as educating personnel about the hazards of SS and how to prevent it, creating a suitable supportive environment for personnel, and providing suitable protective facilities to prevent OR staff from being exposed to SS.
Materials and Methods: This cross-sectional study was conducted from April 2021 to July 2022 in the ORs of 26 public hospitals affiliated to Tabriz University of Medical Sciences. In this research, 396 surgical and anesthesia technologists were included in the study by stratified random sampling. Data were collected using a demographic questionnaire, PSC questionnaire and awareness about the hazards of SS questionnaire and analyzed using SPSS software
Results: The knowledge of the OR staff regarding the hazards of surgical smoke was evaluated at a moderate level with a mean and standard deviation of 9.82±4.32 (range 0 to 21). The average knowledge score of surgical technologists (11.1±4.56) regarding the hazards of surgical smoke was significantly higher than the average score of anesthesia technologists (8.75±4.1)(P=0.02). The PSC in the OR was evaluated at moderate level with a mean and standard deviation of 62.15±11.1 (range 19 to 95). The results of linear regression analysis showed that the effect of PSC in increasing the awareness of OR staff about the hazards of SS was significant (P=0.001). By increasing one score to the total score of the PSC, the awareness score increases by 0.201.
Conclusion: The safety climate of the OR can predict the awareness of the hazards of SS among OR staff. It is recommended to adopt strategies such as educating personnel about the hazards of SS and how to prevent it, creating a suitable supportive environment for personnel, and providing suitable protective facilities to prevent OR staff from being exposed to SS.
Reza Saadat Mehr, Aram Karimian, Kamel Abdi, Fereshteh Bakhshian, Mehran Zarghami,
Volume 17, Issue 1 (3-2023)
Volume 17, Issue 1 (3-2023)
Abstract
Background and Aim: Burned patients experience a high level of anxiety during dress changing. The use of complementary medicine is one of the methods of anxiety management that many studies have conducted about it in recent years. The purpose of this study was to compare the effectiveness of progressive relaxation with abdominal respiration technique on pain anxiety of burn dressing.
Materials and Methods: This study was a randomized clinical trial with a control group. We selected forty-five patients referred to Zare Hospital in Sari through simple sampling and assigned into three groups. The first group received relaxation intervention, the second group received respiratory technique intervention, and no intervention was performed in the control group. Burn Specific Pain Anxiety Scale (BSPAS) was used to measure pain-related anxiety. SPSS software version 20 was used to analyze the data. Descriptive statistics, ANOVA and Tukey’s post hoc test were used for data analysis.
Results: Based on the results, 28% of the participants in the study were single and 72% were married. In terms of age, most of the participants were between 31 and 40 years old. The findings showed that there was no significant difference between the mean pain anxiety levels in the three groups before the intervention. There was a significant difference in the average burn dressing pain anxiety after the intervention between the relaxation group and the control group (P<0.001) and the breathing techniques group and the control group (P<0.000), so that the average burn dressing pain anxiety in the group Relaxation was reduced by 8.60 units as compared to the control group and in the breathing techniques group by 11.60 units as compared to the control group.
Conclusions: The use of relaxation “techniques” and respiratory techniques, which are non-pharmacological methods, are recommended during dress changing in the burned patient. These methods are simple and inexpensive and can reduce the effects of pain anxiety during dress changing.
Materials and Methods: This study was a randomized clinical trial with a control group. We selected forty-five patients referred to Zare Hospital in Sari through simple sampling and assigned into three groups. The first group received relaxation intervention, the second group received respiratory technique intervention, and no intervention was performed in the control group. Burn Specific Pain Anxiety Scale (BSPAS) was used to measure pain-related anxiety. SPSS software version 20 was used to analyze the data. Descriptive statistics, ANOVA and Tukey’s post hoc test were used for data analysis.
Results: Based on the results, 28% of the participants in the study were single and 72% were married. In terms of age, most of the participants were between 31 and 40 years old. The findings showed that there was no significant difference between the mean pain anxiety levels in the three groups before the intervention. There was a significant difference in the average burn dressing pain anxiety after the intervention between the relaxation group and the control group (P<0.001) and the breathing techniques group and the control group (P<0.000), so that the average burn dressing pain anxiety in the group Relaxation was reduced by 8.60 units as compared to the control group and in the breathing techniques group by 11.60 units as compared to the control group.
Conclusions: The use of relaxation “techniques” and respiratory techniques, which are non-pharmacological methods, are recommended during dress changing in the burned patient. These methods are simple and inexpensive and can reduce the effects of pain anxiety during dress changing.
Samaneh Dehghan Abnavi, Afshin Karami Varnamkhasti , Mostafa Roshanzadeh, Fatemeh Kazemi Najafabadi,
Volume 17, Issue 3 (8-2023)
Volume 17, Issue 3 (8-2023)
Abstract
Background and Aim: Communication skills are considered as the most important feature required for health care workers and provide the basis for the development of professional ethics. Since working in the operating room requires team effort and establishing communication between team members, the importance of communication skills in operating room nurses is more visible. Therefore, in the present study was performed, with the aim of determining the effect of virtual training on the principles of professional ethics on communication skills of operating room staff of Ayatollah Kashani and Hajar hospitals of Shahrekord University of Medical Sciences.
Materials and Methods: A quasi-experimental study with a single-group plan before and after in 2020 was performed on 35 operating room staff of Kashani and Hajar teaching hospitals in Shahrekord who were selected by random sampling. Demographic information questionnaire and Queen Dam communication skills questionnaire were used to collect the data. Data analysis was performed by SPSS software using independent t test, Analysis of variance, paired t-test and ANOVA statistics.
Results: Paired t-test showed that the mean of communication skills after the intervention was significantly different from before (P<0.001). The mean of communication skills before the intervention was 65.85±24.52 and after the intervention was 139.77±5.70. No significant relationship was reported between communication skills and age, service history and number of working hours (P>.0.05). Also, there was no significant difference in the average of communication skills according to the variables of gender, marital status, field of study and degree (P>0.05).
Conclusion: The present study showed that professional ethics training was able to improve the communication skills of employees. Therefore, it seems necessary to compile virtual professional ethics training for health care providers and other groups providing health services who do not have enough time to participate in face-to-face classes. According to the results obtained, managers of health systems are recommended to use strategies such as holding workshops on the principles of professional ethics to develop communication skills in their employees.
Materials and Methods: A quasi-experimental study with a single-group plan before and after in 2020 was performed on 35 operating room staff of Kashani and Hajar teaching hospitals in Shahrekord who were selected by random sampling. Demographic information questionnaire and Queen Dam communication skills questionnaire were used to collect the data. Data analysis was performed by SPSS software using independent t test, Analysis of variance, paired t-test and ANOVA statistics.
Results: Paired t-test showed that the mean of communication skills after the intervention was significantly different from before (P<0.001). The mean of communication skills before the intervention was 65.85±24.52 and after the intervention was 139.77±5.70. No significant relationship was reported between communication skills and age, service history and number of working hours (P>.0.05). Also, there was no significant difference in the average of communication skills according to the variables of gender, marital status, field of study and degree (P>0.05).
Conclusion: The present study showed that professional ethics training was able to improve the communication skills of employees. Therefore, it seems necessary to compile virtual professional ethics training for health care providers and other groups providing health services who do not have enough time to participate in face-to-face classes. According to the results obtained, managers of health systems are recommended to use strategies such as holding workshops on the principles of professional ethics to develop communication skills in their employees.
Maryam Bahrami, Somayeh Mohammadi, Mostafa Roshanzadeh, Samaneh Dehghan Abnavi, Ali Taj, Fatemeh Maraki,
Volume 17, Issue 4 (10-2023)
Volume 17, Issue 4 (10-2023)
Abstract
Background and Aim: Operating room students have experienced anxiety for various reasons that affect their educational process such as stitching. Due to the effective role of simulation in improving the education of students, this study was conducted with the aim of the effect of animal skin suturing simulation on the skill level and anxiety level of operating room students.
Materials and Methods: In this study, 30 people (75%) of the samples were aged 18-25 and 10 people (25%) of them were 26-35. 10 people (25%) were men and 30 people (75%) were women. Also, in terms of marriage, 7 people (17.5%) were married and 33 people (82.5%) were single. The present quasi-experimental study was performed with a two-group plan before and after with 40 operating room students of Shahrekord University of Medical Sciences (Shahrekord, Broujen) in 2020. The samples were randomly assigned to two test and control groups using the method based on the purpose of selection. Data were collected before and after the intervention by Spielberger Anxiety Tool and Suturing Skills Questionnaire and analyzed by SPSS software and descriptive and analytical statistical tests (Chi-square test, t-test, paired t-test).
Results: The t-test test showed that the mean of obvious anxiety in the intervention group (36.35±10.22) and the control group (41.15±7.92) after the intervention was not significant (P=0.346). Also, the mean hidden anxiety in the intervention group (36.65±10.47) and the control group (38.65±6.13) had no significant difference (P=0.089). The t-test test showed that there was a significant difference in sewing skills after the intervention in the two intervention groups (28.2±58.22) and the control group (23.42±3.12) (P=0.04).
Conclusion: The texture of suture mannequins is very different from human skin in terms of consistency, and it does not convey the same feeling of sutures on natural skin to students. On the other hand, it is easier to enter and exit and move the needle and thread in the sheepskin, and this provides the students with the possibility of stitching more easily. Therefore, it is suggested to buy and prepare sheep skin for training students and teach them stitches on it.
Shima Moradi, Fatemeh Rezaei Zadeh, Monireh Rahimkhani,
Volume 17, Issue 4 (10-2023)
Volume 17, Issue 4 (10-2023)
Abstract
Background and aim: This study aimed to determine the position of Iran in terms of scientific publications in Immunology and Microbiology, and also to identify the general status of science production and the patterns of publishing in the world, the Middle East, and Iran, analyze Iran scientific collaboration with the Middle East and the world, and explore the relationship between these indicators.
Materials and Methods: The study population contained 30622 Middle Eastern publications in Immunology and Microbiology from 2009 to 2018. Positioning the countries and exploring the relations of indicators, the exploratory factor analysis, and the correlation matrix were conducted using Scival.
Results: According to the findings Iran, Turkey, and Saudi Arabia were among the most powerful countries in the region in terms of publication, citation, regional, international, and overall scientific collaboration. As for regional positioning, the citations had the highest weight comparing to other indicators. Iran have the first rank in the indices of scientific production and citations with 43.63% and 33.76% respectively, third rank in the regional cooperation index with 43.63%, second rank in the extra-regional cooperation index with 23.56%, and also second rank in the total cooperation index with 22.12%.
Conclusion: The indicators were strongly connected togather; however, the citations and international scientific collaborations displayed the strongest amongst others. Despite Iran’s prominent position in both fields, the quality of the publication was lower than the regional and global average. This identified the most powerful and weak countries in the region in regards to scientific capacities in Immunology and Microbiology. Moreover, it reckoned that there was a strong relation between citations and scientific production in contrast with others.
Rasul Bidel Nikoo, Shila Hasanzadeh, Mohamad Jebraeily, Naser Masoudi, Bahlol Rahimi, Farshad Faghisolouk,
Volume 17, Issue 6 (2-2024)
Volume 17, Issue 6 (2-2024)
Abstract
Background and Aim: Traffic accidents in Iran are one of the main causes of mortality and morbidity, identifying the factors related to these accidents can be useful in the prevention and proper management of traffic accidents. The purpose of this study was to determine the epidemiology of trauma caused by traffic accidents in Imam Khomeini hospital in Urmia during 2017-2022.
Materials and Methods: The current research is a cross-sectional descriptive study that was conducted on patients hospitalized due to traffic accidents in Imam Khomeini hospital in Urmia for five years. The required data included demographic characteristics and information of the injured (role of the injured, time of the accident, location of the accident, type of vehicle, damaged area, and condition of the injured during discharge), which was extracted from the trauma registration system of Urmia University of Medical Sciences. After collecting the data, it was entered into SPSS 16 software and described through frequency distribution table and central and dispersion indices
Results: In this study, out of 2086 injured cases, 74.40% (1552 people) were male. The average age of the injured was 34.49 ± 18.47 years. The type of accidental vehicle of most of the injured was motorcycle with 56.70% (998 cases). The most injured were drivers with 52.73% (1100 cases) and among them 57.45% (632 people) were motorcycle riders. 34.08% (711 cases) of injuries to body parts were in the head, neck and face.
Conclusion: The results of this research showed that most of the injured in traffic accidents are young motorcycle drivers and the most injuries were related to the head and neck area. Therefore, by knowing the risk factors and the impact of each of them on the outcome of traffic accidents, it is necessary to carry out appropriate interventions to prevent the risky behaviors of young drivers and create a culture of observing safety tips. Also, in the health system, the necessary preparations in terms of manpower and medical equipment should be made to manage the treatment of injuries caused by traffic accidents.
Materials and Methods: The current research is a cross-sectional descriptive study that was conducted on patients hospitalized due to traffic accidents in Imam Khomeini hospital in Urmia for five years. The required data included demographic characteristics and information of the injured (role of the injured, time of the accident, location of the accident, type of vehicle, damaged area, and condition of the injured during discharge), which was extracted from the trauma registration system of Urmia University of Medical Sciences. After collecting the data, it was entered into SPSS 16 software and described through frequency distribution table and central and dispersion indices
Results: In this study, out of 2086 injured cases, 74.40% (1552 people) were male. The average age of the injured was 34.49 ± 18.47 years. The type of accidental vehicle of most of the injured was motorcycle with 56.70% (998 cases). The most injured were drivers with 52.73% (1100 cases) and among them 57.45% (632 people) were motorcycle riders. 34.08% (711 cases) of injuries to body parts were in the head, neck and face.
Conclusion: The results of this research showed that most of the injured in traffic accidents are young motorcycle drivers and the most injuries were related to the head and neck area. Therefore, by knowing the risk factors and the impact of each of them on the outcome of traffic accidents, it is necessary to carry out appropriate interventions to prevent the risky behaviors of young drivers and create a culture of observing safety tips. Also, in the health system, the necessary preparations in terms of manpower and medical equipment should be made to manage the treatment of injuries caused by traffic accidents.
Parisa Moradimajd, Shahnam Sedighmaroufi, Shaqayeq Taghizadeh, Mr Jamileh Abolghasemi, Alireza Babajani,
Volume 18, Issue 1 (3-2024)
Volume 18, Issue 1 (3-2024)
Abstract
Background and Aim: One of the basic principles in the safety of drug therapy for patients is the correct registration and labeling of anesthetic drugs, which can lead to the reduction of drug errors, the increase of drug and patient safety, the reduction of drug consumption and the environment, and the optimization of hospital costs.
Materials and Methods: This descriptive-analytical and cross-sectional research was conducted in February 2022 in the operating rooms of Iran University of Medical Sciences hospitals. The participants included 177 Anesthesia experts working in the hospitals’ operating rooms, who were included in the study by census method. The data was collected using the checklist for evaluating anesthetic drug registration and labeling guidelines and analyzed using SPSS software and one-way ANOVA, Fisher, and Pearson correlation coefficient statistical tests. The significance level was considered P value < 0.05.
Results: The average compliance with the guidelines for registration and labeling of anesthetic drugs in all hospitals was 3.559 out of the total score of 16. The average adherence to guidelines in 8 hospitals was significantly different from each other (P < 0.001). Hazrat Ali Asghar Hospital had the highest compliance rate, averaging 10.333 out of 16. Firouzgar and Shahid Akbarabadi hospitals were in the next rank, averaging 10.11 and 6.65, respectively. There was a negative and significant correlation between the level of compliance with the guidelines and the average work experience and age of the experts (P=0/17); However, gender did not significantly correlate with the degree of adherence to the guidelines(P=0/596).
Conclusion: According to the obtained results, compliance with the guidelines for registration and labeling of anesthetic drugs in most hospitals was assessed as weak and at an unfavorable level. Considering the importance of this issue in reducing medication errors and increasing patient safety, it is necessary to use empowerment and retraining courses for Anesthesia experts according to the latest guidelines.
Mehdi Raadabadi, Zahra Tolideh, Zahra Shoara, Zahra Yeganeh, Jamil Sadeghifar, Khalil Momeni,
Volume 18, Issue 1 (3-2024)
Volume 18, Issue 1 (3-2024)
Abstract
Background and Aim: There is limited evidence about the effect of the corona disease epidemic on the efficiency of hospitals in Iran. This study was conducted with the aim of investigating the effect of the Covid-19 epidemic on the productivity of public hospitals in Ilam province.
Materials and Methods: This retrospective descriptive research has investigated the performance of 9 hospitals in Ilam province during a four-year period(1397-1400) based on the Pabon Lasso graphic model. The desired data were extracted from the HIS system of the hospitals and the key performance indicators of BOR, BTR and ALOS were calculated. The Pabon Lasso diagram was drawn with Excel software.
Results: The results showed that the bed occupancy percentage in teaching hospitals is significantly higher than non-teaching hospitals (P<0.05). Based on the results, the percentage of bed occupancy and the rate of bed rotation after the covid 19 pandemic has decreased significantly (P<0.05). The average length of the stay of patients also increased after the pandemic (P<0.05). Overall evaluation of hospital efficiency based on the Pabén Lasso model shows that the frequency of hospitals located in Nakara district has decreased from 4 hospitals before the pandemic to 3 hospitals, although hospitals in Kara district have not changed during this period.
Conclusion: Most of the researched hospitals, especially non-teaching hospitals, have low bed occupancy. Weakness in the service delivery chain, especially diagnostic services and specialized and super-specialized services, is one of the main reasons for this situation. Moving towards a change in the way hospitals are managed and having more flexibility in the structure and implementation in the short term and prioritizing large hospitals with a complete chain of services can lead to a way out of the current inefficient situation.
Materials and Methods: This retrospective descriptive research has investigated the performance of 9 hospitals in Ilam province during a four-year period(1397-1400) based on the Pabon Lasso graphic model. The desired data were extracted from the HIS system of the hospitals and the key performance indicators of BOR, BTR and ALOS were calculated. The Pabon Lasso diagram was drawn with Excel software.
Results: The results showed that the bed occupancy percentage in teaching hospitals is significantly higher than non-teaching hospitals (P<0.05). Based on the results, the percentage of bed occupancy and the rate of bed rotation after the covid 19 pandemic has decreased significantly (P<0.05). The average length of the stay of patients also increased after the pandemic (P<0.05). Overall evaluation of hospital efficiency based on the Pabén Lasso model shows that the frequency of hospitals located in Nakara district has decreased from 4 hospitals before the pandemic to 3 hospitals, although hospitals in Kara district have not changed during this period.
Conclusion: Most of the researched hospitals, especially non-teaching hospitals, have low bed occupancy. Weakness in the service delivery chain, especially diagnostic services and specialized and super-specialized services, is one of the main reasons for this situation. Moving towards a change in the way hospitals are managed and having more flexibility in the structure and implementation in the short term and prioritizing large hospitals with a complete chain of services can lead to a way out of the current inefficient situation.
Ali Mohammad Mosadeghrad, Mahdiyeh Heydari, Mahya Abbasi, Mahdi Abbasi,
Volume 18, Issue 2 (5-2024)
Volume 18, Issue 2 (5-2024)
Abstract
Background and Aim: Health insurance organizations play an important role in increasing people’s access to health services and protecting them financially against catastrophic health costs. Iran Health Insurance Organization (IHIO) is one of the largest public health insurance organizations in Iran, which faces many challenges. The purpose of this research is the strategic analysis of health financing performance of IHIO.
Materials and Methods: This qualitative research was conducted using interpretive phenomenology method through using semi-structured interviews with 25 managers and employees of IHIO. In addition, relevant documents and archival data of IHIO were collected and analyzed. Thematic analysis method was used to analyze the data.
Results: Overall, 19 strengths, 24 weaknesses, 14 opportunities, 37 threats and 43 solutions were identified for the health financing system of IHIO. Increasing the coverage of health services, correcting the information databases of the insured and electronic prescribing were the most important strengths, and inappropriate pooling of financial resources, incomplete risk pooling, high administrative costs, and inefficient control were the most important weaknesses of IHIO. The most important opportunities for IHIO include the government’s support for universal health coverage and emphasis on primary health care, legal support for consolidating health insurance funds and improving the health technology assessment system in the country. The main threats to IHIO include political and economic unstability, low health insurance premiums, decisions without scientific support and insufficient enforcement of laws. Finally, solutions such as modernizing the tax system, increasing the health literacy of the community, reducing bureaucracy, increasing transparency and accountability, and reforming the monitoring and evaluation system were identified to strengthen the performance of the financing system of IHIO.
Conclusion: Iran’s health insurance organization is facing numerous structural, contexual and process challenges that have reduced its productivity. Decrease in revenues, increase in costs and decrease in efficiency have caused problems in the financing performance of this organization. Recognizing the weaknesses and challenges of financing performance and applying corrective interventions is the first step in strengthening the sustainability of health financing of IHIO.
Materials and Methods: This qualitative research was conducted using interpretive phenomenology method through using semi-structured interviews with 25 managers and employees of IHIO. In addition, relevant documents and archival data of IHIO were collected and analyzed. Thematic analysis method was used to analyze the data.
Results: Overall, 19 strengths, 24 weaknesses, 14 opportunities, 37 threats and 43 solutions were identified for the health financing system of IHIO. Increasing the coverage of health services, correcting the information databases of the insured and electronic prescribing were the most important strengths, and inappropriate pooling of financial resources, incomplete risk pooling, high administrative costs, and inefficient control were the most important weaknesses of IHIO. The most important opportunities for IHIO include the government’s support for universal health coverage and emphasis on primary health care, legal support for consolidating health insurance funds and improving the health technology assessment system in the country. The main threats to IHIO include political and economic unstability, low health insurance premiums, decisions without scientific support and insufficient enforcement of laws. Finally, solutions such as modernizing the tax system, increasing the health literacy of the community, reducing bureaucracy, increasing transparency and accountability, and reforming the monitoring and evaluation system were identified to strengthen the performance of the financing system of IHIO.
Conclusion: Iran’s health insurance organization is facing numerous structural, contexual and process challenges that have reduced its productivity. Decrease in revenues, increase in costs and decrease in efficiency have caused problems in the financing performance of this organization. Recognizing the weaknesses and challenges of financing performance and applying corrective interventions is the first step in strengthening the sustainability of health financing of IHIO.
Sedigheh Hannani, Parsa Farmahin Farahany, Fardin Amiri,
Volume 18, Issue 3 (7-2024)
Volume 18, Issue 3 (7-2024)
Abstract
Background and Aim: The usual trainings are not enough to acquire the knowledge and skills of operating room students to play the role of scrub and mobile person, especially in complex and specialized surgeries. This research was conducted with the aim of determining the effect of designing, implementing and evaluating the protocol before, during and after Whipple surgery and its effect on the knowledge, attitude and clinical skills of surgical technology students of Iran University of Medical Sciences.
Materials and Methods: This research was a semi-experimental study of pre- and post-intervention type, during which 50, fifth and seventh semester undergraduate students of surgical technology were selected and trained using the designed protocol. The content of the protocol included the latest principles of Whipple surgery technology in the field of surgical anatomy, pathology of the digestive system and pancreas, diagnostic procedures and preparations before Whipple surgery, the procedure of Whipple surgery and the post-surgery phase and the recovery period of Whipple surgery. Before and after the training, the amount of knowledge, attitude and clinical skills of the students were evaluated and compared using a questionnaire and an observational checklist. The data were analyzed using paired t-test, non-parametric Wilcoxon test and analysis of covariance test in SPSS software.
Results: The results of this study showed that after using the designed educational protocol, the knowledge, attitude and clinical skills of surgical technology students increased. That is, the use of the designed educational protocol was effective on the level of knowledge, attitude and especially the clinical skills of the students. So that a statistically significant difference was observed in the average scores of the knowledge, attitude and clinical skill test of the students before and after training (P<0.05).
Conclusion: Based on the results of this study, designing and using educational protocols is an effective method in the process of teaching and evaluating the level of knowledge, attitude and clinical skills of students in complex and specialized surgeries such as Whipple surgery. Therefore, the use of educational protocols designed in the process of teaching students is recommended to all professors and educational officials of surgical technology.
Materials and Methods: This research was a semi-experimental study of pre- and post-intervention type, during which 50, fifth and seventh semester undergraduate students of surgical technology were selected and trained using the designed protocol. The content of the protocol included the latest principles of Whipple surgery technology in the field of surgical anatomy, pathology of the digestive system and pancreas, diagnostic procedures and preparations before Whipple surgery, the procedure of Whipple surgery and the post-surgery phase and the recovery period of Whipple surgery. Before and after the training, the amount of knowledge, attitude and clinical skills of the students were evaluated and compared using a questionnaire and an observational checklist. The data were analyzed using paired t-test, non-parametric Wilcoxon test and analysis of covariance test in SPSS software.
Results: The results of this study showed that after using the designed educational protocol, the knowledge, attitude and clinical skills of surgical technology students increased. That is, the use of the designed educational protocol was effective on the level of knowledge, attitude and especially the clinical skills of the students. So that a statistically significant difference was observed in the average scores of the knowledge, attitude and clinical skill test of the students before and after training (P<0.05).
Conclusion: Based on the results of this study, designing and using educational protocols is an effective method in the process of teaching and evaluating the level of knowledge, attitude and clinical skills of students in complex and specialized surgeries such as Whipple surgery. Therefore, the use of educational protocols designed in the process of teaching students is recommended to all professors and educational officials of surgical technology.
Alireza Jafarkhani, Behzad Imani, Sina Ghasemi,
Volume 18, Issue 4 (10-2024)
Volume 18, Issue 4 (10-2024)
Abstract
Background and Aim: Today, an important part of the surgeries performed in the operating room are emergency surgeries. Surgeries are generally necessary in the face of acute life-threatening conditions. Today, due to the increase in the number of emergency surgeries performed in hospitals and the challenging nature of these surgeries, several problems have arisen in the operating room. This study aimed to explain the lived experience of operating room nurses of the challenges that arise following the admission of emergency patients.
Materials and Methods: This research is a qualitative study that was conducted using descriptive phenomenology in 2023 in all hospitals affiliated with Hamadan University of Medical Sciences. The samples of this study were selected using purposeful and snowball sampling. In this research, data were collected through 10 semi-structured interviews with operating room nurses. The data obtained were analyzed to determine the main and sub-categories using Colaizzi’s method
Results: The results of this study showed that the average age of the participants was 46.2 years and their average work experience was 18.5 years. After analyzing the interviews, it was found that the challenges arising from the admission of emergency patients from the perspective of the experiences of operating room nurses are classified into three main themes and 10 subthemes. The main themes of this study include operating room supplies and infrastructure (structural limitations of the operating room, provision of human resources for emergency surgeries, provision of equipment and tools required for surgery, and negligence in providing timely medical services), clinical risks during surgery (threat to patient safety, disregard for observing the principles of sterility and the patient's unique physical condition), and coordination and communication (unconstructive interaction of the surgeon with staff, unusual behaviors of companions in the operating room, and insufficient support for the patient by others).
Conclusion: To prevent challenges, early identification is essential. By planning and implementing preventive measures, improving nurse training, improving infrastructure, and strengthening interdisciplinary collaboration, we can improve the quality of emergency surgical procedures and increase patient satisfaction.
Materials and Methods: This research is a qualitative study that was conducted using descriptive phenomenology in 2023 in all hospitals affiliated with Hamadan University of Medical Sciences. The samples of this study were selected using purposeful and snowball sampling. In this research, data were collected through 10 semi-structured interviews with operating room nurses. The data obtained were analyzed to determine the main and sub-categories using Colaizzi’s method
Results: The results of this study showed that the average age of the participants was 46.2 years and their average work experience was 18.5 years. After analyzing the interviews, it was found that the challenges arising from the admission of emergency patients from the perspective of the experiences of operating room nurses are classified into three main themes and 10 subthemes. The main themes of this study include operating room supplies and infrastructure (structural limitations of the operating room, provision of human resources for emergency surgeries, provision of equipment and tools required for surgery, and negligence in providing timely medical services), clinical risks during surgery (threat to patient safety, disregard for observing the principles of sterility and the patient's unique physical condition), and coordination and communication (unconstructive interaction of the surgeon with staff, unusual behaviors of companions in the operating room, and insufficient support for the patient by others).
Conclusion: To prevent challenges, early identification is essential. By planning and implementing preventive measures, improving nurse training, improving infrastructure, and strengthening interdisciplinary collaboration, we can improve the quality of emergency surgical procedures and increase patient satisfaction.
Hojjat Rahmani, Sadegh Moradi, Nayeb Fadaei Dehcheshmeh,
Volume 18, Issue 4 (10-2024)
Volume 18, Issue 4 (10-2024)
Abstract
Background and Aim: The fundamental right and most valuable asset for all strata of society is the enjoyment of health. Individuals residing in nomadic settings face geographical, social, cultural, and linguistic barriers when seeking access to essential services. The provision of healthcare services to nomads has become a complex issue due to the nature of the lifestyle. The aim of this study was to assess the challenges in the provision of healthcare services among the nomads in the Khuzestan province.
Materials and Methods: This study uses a qualitative approach, involving seventeen managers and staff from health centers affiliated with Ahvaz University of Medical Sciences. The data collection approach was inductive. Data were gathered through individual interviews, and participants’ opinions were recorded. The data were analyzed using the conventional content analysis method with a mixed approach (deductive and inductive). The credibility and quality of the data were assessed using the Guba and Lincoln method.
Results: The challenges in providing healthcare services in nomads were identified in nine categories and three overarching themes. The themes encompassed the nature and characteristics of the non-sedentary populations, the healthcare system, and the responsibilities of other sectors. The nature and characteristics of the nomads were categorized into five categories: demographic, cultural, climatic-geographic, socio-ethnic-tribal, and lifestyle. The healthcare delivery comprises of two aspects: structural and procedural. Additionally, the duties of other development sectors were categorized into two categories: infrastructures and inter-sectoral collaborations. The results showed that nomads face barriers to receiving healthcare due to the inherent characteristics of them, the healthcare system, and the performance of other organizations. The unstable population, cultural diversity, scattered distribution of the population, and their ethnic and migration-based lifestyle are among the inherent characteristics of nomads that impact the provision of services.
Conclusion: The provision of health services to nomads is influenced by recipients’ and providers’ characteristics. Decision-makers and managers, considering the unique conditions of life in the design and implementation of health programs, decision-makers and managers should prioritize strengthening healthcare networks in hard-to-reach areas. Given the limited resources and infrastructure weaknesses in settlements, inter-sectoral collaboration and the development of resources and infrastructure (applying the One Health approach) are important.
Materials and Methods: This study uses a qualitative approach, involving seventeen managers and staff from health centers affiliated with Ahvaz University of Medical Sciences. The data collection approach was inductive. Data were gathered through individual interviews, and participants’ opinions were recorded. The data were analyzed using the conventional content analysis method with a mixed approach (deductive and inductive). The credibility and quality of the data were assessed using the Guba and Lincoln method.
Results: The challenges in providing healthcare services in nomads were identified in nine categories and three overarching themes. The themes encompassed the nature and characteristics of the non-sedentary populations, the healthcare system, and the responsibilities of other sectors. The nature and characteristics of the nomads were categorized into five categories: demographic, cultural, climatic-geographic, socio-ethnic-tribal, and lifestyle. The healthcare delivery comprises of two aspects: structural and procedural. Additionally, the duties of other development sectors were categorized into two categories: infrastructures and inter-sectoral collaborations. The results showed that nomads face barriers to receiving healthcare due to the inherent characteristics of them, the healthcare system, and the performance of other organizations. The unstable population, cultural diversity, scattered distribution of the population, and their ethnic and migration-based lifestyle are among the inherent characteristics of nomads that impact the provision of services.
Conclusion: The provision of health services to nomads is influenced by recipients’ and providers’ characteristics. Decision-makers and managers, considering the unique conditions of life in the design and implementation of health programs, decision-makers and managers should prioritize strengthening healthcare networks in hard-to-reach areas. Given the limited resources and infrastructure weaknesses in settlements, inter-sectoral collaboration and the development of resources and infrastructure (applying the One Health approach) are important.
Mahdieh Jafari, Majid Razavi, Sepideh Fanaei Nookar, Mehryar Taghavi Gilani,
Volume 19, Issue 1 (4-2025)
Volume 19, Issue 1 (4-2025)
Abstract
Background and Aim: Hypertension is one of the most common comorbidities in cataract surgery and severe hypertension sometimes cause surgery to be postponed. The purpose of this study is to evaluate the relationship between preoperative hypertension and intraoperative hemodynamic changes and postoperative early cardiovascular and cerebral complications on cataract surgery.
Materials and Methods: This study was performed on 160 patients with cataract surgery in Mashhad Khatam-al-anbia hospital. Before induction, the patients were divided into three groups by blood pressure measurement: normotensive (blood pressure <140/90) 100 patients, hypertensive (blood pressure 140/90 to 180/110) 30 patients and hypertensive crisis (blood pressure>180/110) 30 patients. Blood pressure and heart rate were assessed before entering to operating room, before induction and every 5 minutes to the end of surgery, after recovery and ward transfer. Cardiovascular and neurological complications were assessed 24 hours after surgery. Data were analyzed by SPSS software. P<0.05 was considered significant.
Results: There was no significant difference between patients for demographic and preoperative hemodynamic parameters. Preinduction, the blood pressure increased compared to the ward, which was more significant in the hypertensive and hypertensive crisis groups (P=0.001). After induction, systolic blood pressure reduced which was more significant in the hypertensive crisis group than two other groups (P=0.001). The heart rate increased after transferring to the operation room and returned to normal after induction of anesthesia, but in three groups were not statistically significant (P=0.25). Systolic blood pressure < 90 mmHg during the surgery, and also cardiovascular and nervous complications up to 24 hours were not significantly different in three groups (P=0.75 and P=0.08, respectively).
Conclusion: Blood pressure instability was more common in patients with hypertension crisis, but no early or debilitating complications were observed. Primary hemodynamic changes were rapidly reduced and controlled by induction of anesthesia. According to the findings, preinduction blood pressure alone is not sufficient to cancellation of cataract surgery.
Materials and Methods: This study was performed on 160 patients with cataract surgery in Mashhad Khatam-al-anbia hospital. Before induction, the patients were divided into three groups by blood pressure measurement: normotensive (blood pressure <140/90) 100 patients, hypertensive (blood pressure 140/90 to 180/110) 30 patients and hypertensive crisis (blood pressure>180/110) 30 patients. Blood pressure and heart rate were assessed before entering to operating room, before induction and every 5 minutes to the end of surgery, after recovery and ward transfer. Cardiovascular and neurological complications were assessed 24 hours after surgery. Data were analyzed by SPSS software. P<0.05 was considered significant.
Results: There was no significant difference between patients for demographic and preoperative hemodynamic parameters. Preinduction, the blood pressure increased compared to the ward, which was more significant in the hypertensive and hypertensive crisis groups (P=0.001). After induction, systolic blood pressure reduced which was more significant in the hypertensive crisis group than two other groups (P=0.001). The heart rate increased after transferring to the operation room and returned to normal after induction of anesthesia, but in three groups were not statistically significant (P=0.25). Systolic blood pressure < 90 mmHg during the surgery, and also cardiovascular and nervous complications up to 24 hours were not significantly different in three groups (P=0.75 and P=0.08, respectively).
Conclusion: Blood pressure instability was more common in patients with hypertension crisis, but no early or debilitating complications were observed. Primary hemodynamic changes were rapidly reduced and controlled by induction of anesthesia. According to the findings, preinduction blood pressure alone is not sufficient to cancellation of cataract surgery.
Mohammad Ghasembandi, Samaneh Dehghan Abnavi, Negin Larti, Foziye Hamoole Tahmasbi, Jaber Zabihirad,
Volume 19, Issue 1 (4-2025)
Volume 19, Issue 1 (4-2025)
Abstract
Background and Aim: Low back pain (LBP) is one of the most common musculoskeletal disorders among operating room nurses, and numerous studies have well explained its causes and factors. However, studies focusing on the characteristics and dimensions of low back pain and its relationship with influencing factors have not been conducted. Therefore, the aim of this study was to investigate the prevalence of the type of LBP, duration of back pain, and severity of back pain, and their relationship with the demographic characteristics of operating room nurses.
Materials and Methods: This cross-sectional study was conducted on 350 operating room nurses at Ahvaz teaching hospitals in Iran in 2023. Data were collected using a questionnaire that included demographic information and LBP characteristics. Data were analyzed using IBM SPSS.
Results: 64.8% of the subjects were female, 63.5% were married, and their mean age was 33.83±7.02 years. The prevalence of LBP among operating room nurses was 74.3%. In 60.7% of participant who have LBP, the first experience of back pain was in the past 5 years. The most common diagnosis of LBP was muscular disorders (29.9%). Also, 57.3% of them had pain only in the lower back and 42.7% of them had LBP radiating to the legs. We found no statistically significant relationship between the duration and severity of LBP and demographic characteristics (P<0.05). A statistically significant relationship was found between the type of LBP and gender and level of education, as well as between the duration of LBP and severity of LBP (P<0.05).
Conclusion: The findings of this study showed a high prevalence of LBP among operating room nurses, and differences in the type of LBP were observed based on gender and educational level, which may be attributed to individual factors. Additionally, the significant relationship between the duration of LBP and its severity may indicate the effect of the long duration of LBP on its severity, which suggests that providing counseling and treatment programs for nurses who are in the early stages of LBP.
Results: 64.8% of the subjects were female, 63.5% were married, and their mean age was 33.83±7.02 years. The prevalence of LBP among operating room nurses was 74.3%. In 60.7% of participant who have LBP, the first experience of back pain was in the past 5 years. The most common diagnosis of LBP was muscular disorders (29.9%). Also, 57.3% of them had pain only in the lower back and 42.7% of them had LBP radiating to the legs. We found no statistically significant relationship between the duration and severity of LBP and demographic characteristics (P<0.05). A statistically significant relationship was found between the type of LBP and gender and level of education, as well as between the duration of LBP and severity of LBP (P<0.05).
Conclusion: The findings of this study showed a high prevalence of LBP among operating room nurses, and differences in the type of LBP were observed based on gender and educational level, which may be attributed to individual factors. Additionally, the significant relationship between the duration of LBP and its severity may indicate the effect of the long duration of LBP on its severity, which suggests that providing counseling and treatment programs for nurses who are in the early stages of LBP.
Nabeel Taher Jameel Alghanim, Hamed Jadooa Abbas, Hamid Choobineh, Ziba Majidi, Nasrin Dashti,
Volume 19, Issue 2 (7-2025)
Volume 19, Issue 2 (7-2025)
Abstract
Background and Aim: This study investigated the biochemical profiles of individuals with different stages of kidney disease, including those with kidney disease without hemodialysis, chronic kidney disease without hemodialysis, and individuals with renal failure undergoing hemodialysis treatment, to clarify the role of mineral markers, inflammation, and kidney function in the complications of this disease.
Materials and Methods: This case-control study was conducted with 180 participants aged 18 to 81 years in Iraq. Participants were divided into four groups: the case group (including individuals with kidney disease not on dialysis, chronic kidney disease not on dialysis, and kidney failure treated with dialysis) and the control group, which included healthy individuals. Blood levels of urea, creatinine, calcium, phosphorus, vitamin D3, parathyroid hormone (PTH), high-sensitivity C-reactive protein (hs-CRP), and cystatin C were measured.
Results: The results showed that the levels of blood urea, calcium, vitamin D3, cystatin C and hs-CRP were significantly different between the different groups. The mean creatinine in the non-dialysis kidney disease group (3.98±1.77 mg/dL) and non-dialysis chronic kidney disease (4.59±1.63 mg/dL) was different from the dialysis kidney failure group (11.03±3.35 mg/dL) (P=0.001), but there was no significant difference between the two groups of kidney disease without dialysis and chronic kidney disease without dialysis. The phosphorus concentration was significant in all groups (P=0.001) and the highest value was observed in the dialysis kidney failure group. The PTH level was not significantly different between the two groups of non-dialysis, but there was a significant difference compared to the dialysis kidney failure group (P=0.001). Cystatin C was not significantly different in the two non-dialysis groups, but was significantly higher (P=0.001) compared with the renal failure group on dialysis (7.06±1.61 mg/dL).
Conclusion: This study demonstrated that regular monitoring of biochemical biomarkers is essential for the timely diagnosis and effective management of kidney disease. It also highlights the importance of paying attention to metabolic and inflammatory abnormalities in patients with kidney disease (especially in patients on dialysis), including extensive changes in biochemical, hormonal, and inflammatory factors levels that often occur due to severe impairment of kidney function and the dialysis process.
Materials and Methods: This case-control study was conducted with 180 participants aged 18 to 81 years in Iraq. Participants were divided into four groups: the case group (including individuals with kidney disease not on dialysis, chronic kidney disease not on dialysis, and kidney failure treated with dialysis) and the control group, which included healthy individuals. Blood levels of urea, creatinine, calcium, phosphorus, vitamin D3, parathyroid hormone (PTH), high-sensitivity C-reactive protein (hs-CRP), and cystatin C were measured.
Results: The results showed that the levels of blood urea, calcium, vitamin D3, cystatin C and hs-CRP were significantly different between the different groups. The mean creatinine in the non-dialysis kidney disease group (3.98±1.77 mg/dL) and non-dialysis chronic kidney disease (4.59±1.63 mg/dL) was different from the dialysis kidney failure group (11.03±3.35 mg/dL) (P=0.001), but there was no significant difference between the two groups of kidney disease without dialysis and chronic kidney disease without dialysis. The phosphorus concentration was significant in all groups (P=0.001) and the highest value was observed in the dialysis kidney failure group. The PTH level was not significantly different between the two groups of non-dialysis, but there was a significant difference compared to the dialysis kidney failure group (P=0.001). Cystatin C was not significantly different in the two non-dialysis groups, but was significantly higher (P=0.001) compared with the renal failure group on dialysis (7.06±1.61 mg/dL).
Conclusion: This study demonstrated that regular monitoring of biochemical biomarkers is essential for the timely diagnosis and effective management of kidney disease. It also highlights the importance of paying attention to metabolic and inflammatory abnormalities in patients with kidney disease (especially in patients on dialysis), including extensive changes in biochemical, hormonal, and inflammatory factors levels that often occur due to severe impairment of kidney function and the dialysis process.
Mahnaz Moghadari Koosha, Iraj Salehi, Elaheh Mousavi, Mohammad Reza Safari, Nasim Alipour, Hossein Vakili Mofrad,
Volume 19, Issue 4 (11-2025)
Volume 19, Issue 4 (11-2025)
Abstract
Background and Aim: The hidden curriculum is considered the most powerful means of transmitting professional values. Given the critical importance of managing the hidden curriculum to institutionalize professional ethics and professionalism within health higher education institutions, the present study was conducted to explore the perceptions of operating room and anesthesia students and instructors regarding the impact of the hidden curriculum on the promotion of professional ethics.
Materials and Methods: This study was conducted using a qualitative approach based on conventional content analysis. The study population included final-year students and instructors from the operating room and anesthesia disciplines at Hamadan University of Medical Sciences. Participants were selected through purposive and theoretical sampling methods. Data were collected via in-depth, semi-structured interviews. Data saturation was achieved after conducting 24 interviews. The data analysis followed the qualitative content analysis approach proposed by Graneheim and Lundman (2004), and was carried out in seven steps: 1. familiarization with the data, 2. identification of meaning units, 3. initial coding, 4. formation of subcategories, 5. development of categories, 6. extraction of themes, and 7. final review.
Results: The content analysis of the interviews resulted in the identification of 456 initial codes. Following refinement and consolidation, these codes were organized into four overarching categories and ten subcategories. The main categories comprised: ‘Components of the hidden curriculum in professional ethics education’, ‘Mechanisms through which the hidden curriculum exerts influence’, ‘Consequences of the hidden curriculum’, and ‘Strategies for enhancing professional ethics’. The findings indicated that the hidden curriculum, manifested through the behavioral patterns of faculty members and instructors, organizational culture, and interpersonal interactions, plays a pivotal role in shaping students’ ethical attitudes and behaviors. Furthermore, the hidden curriculum, through processes of unconscious learning, reinforcement or erosion of formal values, and the manner in which rules are implemented, can yield both positive outcomes—such as the development of ethical decision-making skills—and negative outcomes, including diminished ethical sensitivity.
Conclusion: This study revealed that the hidden curriculum in operating room and anesthesia education functions as a dual-force phenomenon. On one hand, it fosters the development of professional ethics through constructive role modeling and authentic clinical experiences. On the other hand, it can contribute to ethical erosion by conveying contradictory messages and unhealthy norms. Achieving sustainable ethical learning requires active management of the hidden curriculum through three key strategies: aligning the formal and hidden curricula, empowering instructors as agents of ethical value transmission, and shifting the organizational culture paradigm toward learning from error.
Materials and Methods: This study was conducted using a qualitative approach based on conventional content analysis. The study population included final-year students and instructors from the operating room and anesthesia disciplines at Hamadan University of Medical Sciences. Participants were selected through purposive and theoretical sampling methods. Data were collected via in-depth, semi-structured interviews. Data saturation was achieved after conducting 24 interviews. The data analysis followed the qualitative content analysis approach proposed by Graneheim and Lundman (2004), and was carried out in seven steps: 1. familiarization with the data, 2. identification of meaning units, 3. initial coding, 4. formation of subcategories, 5. development of categories, 6. extraction of themes, and 7. final review.
Results: The content analysis of the interviews resulted in the identification of 456 initial codes. Following refinement and consolidation, these codes were organized into four overarching categories and ten subcategories. The main categories comprised: ‘Components of the hidden curriculum in professional ethics education’, ‘Mechanisms through which the hidden curriculum exerts influence’, ‘Consequences of the hidden curriculum’, and ‘Strategies for enhancing professional ethics’. The findings indicated that the hidden curriculum, manifested through the behavioral patterns of faculty members and instructors, organizational culture, and interpersonal interactions, plays a pivotal role in shaping students’ ethical attitudes and behaviors. Furthermore, the hidden curriculum, through processes of unconscious learning, reinforcement or erosion of formal values, and the manner in which rules are implemented, can yield both positive outcomes—such as the development of ethical decision-making skills—and negative outcomes, including diminished ethical sensitivity.
Conclusion: This study revealed that the hidden curriculum in operating room and anesthesia education functions as a dual-force phenomenon. On one hand, it fosters the development of professional ethics through constructive role modeling and authentic clinical experiences. On the other hand, it can contribute to ethical erosion by conveying contradictory messages and unhealthy norms. Achieving sustainable ethical learning requires active management of the hidden curriculum through three key strategies: aligning the formal and hidden curricula, empowering instructors as agents of ethical value transmission, and shifting the organizational culture paradigm toward learning from error.
Maryam Amirshekari, Seyyedeh Maryam Seyyedi, Faeze Fakhri, Mohsen Yaghmaei,
Volume 19, Issue 4 (11-2025)
Volume 19, Issue 4 (11-2025)
Abstract
Background and Aim: Shift handover is one of the key processes in clinical settings, during which patient care is transferred from one healthcare team to the next. Weaknesses in this process—particularly in high-pressure environments such as operating rooms—may lead to reduced quality of information transfer and staff dissatisfaction. This study aimed to determine the effect of the standard SBAR communication model on the quality of the shift handover process and the satisfaction of operating room personnel.
Materials and Methods: This quasi-experimental study with a pretest–posttest design was conducted in 2023 at Imam Khomeini Hospital in Jiroft. Sampling was performed using a census method, and a total of 66 operating room staff members participated in the study. The intervention consisted of a two-hour training session (including theoretical and practical components) on the SBAR model. Data were collected using the standard CEX checklist to assess handover quality and a modified version of the Petrovic questionnaire to evaluate staff satisfaction. The validity and reliability of the instruments were confirmed. Data analysis was performed using SPSS and paired t-tests. A significance level of less than 0.05 was considered.
Results: The study participants included 66 operating room staff members, comprising 39 women and 27 men, with a mean age of 30.2±2.45 years. The mean score of shift handover quality significantly increased after SBAR training, rising from 73.80±13.99 before the training to 102.18±10.69 after the training, which corresponds to an improvement of approximately 20.9% relative to the total score range of the instrument (P<0.001). Furthermore, staff satisfaction with the shift handover process also improved, increasing from 37.85±4.77 to 42.41±4.76, representing an improvement of approximately 11.4% relative to the total instrument score range (P<0.001). These changes indicate the positive impact of SBAR training on both the shift handover process and the staff experience.
Conclusion: The findings indicated that training and implementation of the SBAR model were associated with significant improvements in handover quality and staff satisfaction. These results suggest that using structured communication tools may help improve certain aspects of the handover process. However, due to the lack of a control group and the short follow-up period, it is not possible to draw firm conclusions about the long-term effects of the intervention. Therefore, SBAR-based training may be considered as a recommended option; however, further studies with stronger designs and in diverse clinical settings are needed to more accurately evaluate its outcomes.
Materials and Methods: This quasi-experimental study with a pretest–posttest design was conducted in 2023 at Imam Khomeini Hospital in Jiroft. Sampling was performed using a census method, and a total of 66 operating room staff members participated in the study. The intervention consisted of a two-hour training session (including theoretical and practical components) on the SBAR model. Data were collected using the standard CEX checklist to assess handover quality and a modified version of the Petrovic questionnaire to evaluate staff satisfaction. The validity and reliability of the instruments were confirmed. Data analysis was performed using SPSS and paired t-tests. A significance level of less than 0.05 was considered.
Results: The study participants included 66 operating room staff members, comprising 39 women and 27 men, with a mean age of 30.2±2.45 years. The mean score of shift handover quality significantly increased after SBAR training, rising from 73.80±13.99 before the training to 102.18±10.69 after the training, which corresponds to an improvement of approximately 20.9% relative to the total score range of the instrument (P<0.001). Furthermore, staff satisfaction with the shift handover process also improved, increasing from 37.85±4.77 to 42.41±4.76, representing an improvement of approximately 11.4% relative to the total instrument score range (P<0.001). These changes indicate the positive impact of SBAR training on both the shift handover process and the staff experience.
Conclusion: The findings indicated that training and implementation of the SBAR model were associated with significant improvements in handover quality and staff satisfaction. These results suggest that using structured communication tools may help improve certain aspects of the handover process. However, due to the lack of a control group and the short follow-up period, it is not possible to draw firm conclusions about the long-term effects of the intervention. Therefore, SBAR-based training may be considered as a recommended option; however, further studies with stronger designs and in diverse clinical settings are needed to more accurately evaluate its outcomes.
Parsa Farmahin Farahany, Maryam Amirshekari, Mohsen Yaghmaie,
Volume 19, Issue 5 (12-2025)
Volume 19, Issue 5 (12-2025)
Abstract
Background and Aim: Designing a standard surgical preference card and implementing it in the operating room environment can partially solve the problems related to the variety of surgical procedures and the preparation of tools and equipment required for each surgical procedure. The present study aimed to determine the effect of designing and implementing surgical preference card software on the clinical skills of operating room students at Jiroft University of Medical Sciences.
Materials and Methods: This study was a semi-experimental intervention study in which 70 operating room students from the 4th, 6th, and 8th semesters of the undergraduate operating room program were selected through a census method and were trained using educational software designed by the researcher. Before and after the training, their clinical skills were assessed using a researcher-made questionnaire and checklist. To confirm the validity of the questionnaires and the researcher-made checklist, the opinion of an expert panel (12 expert faculty members) and the consensus of peer reviewers were used. Then, the data were analyzed in SPSS software using descriptive statistics, paired t-test, nonparametric Wilcoxon test, and analysis of covariance test.
Results: According to the research findings, the use of the designed software was effective on the clinical skills of operating room students. Based on the results of the Willcocson tests, a significant difference was observed in the mean scores of the students’ clinical skills test before and after implementing the designed software. The results of the study showed that the clinical skill scores of the students increased after using the software. The maximum scores of the samples are calculated from 100 points. The average clinical skill score of the subjects in the study increased from 40.98 before the educational intervention to 92.36 after the intervention, and the students had a higher level of skill in preparing the items and tools needed by the surgical team in all three stages before, during, and after surgery. Also, in the study, no relationship was found between any of the demographic variables studied, such as age, gender, and academic semester, and the clinical skills of the study members (P<0/05).
Conclusion: Based on the results of the present study, the design and use of surgical preference card software in training procedure of operating room students has had an impact on improve their clinical skills. Therefore, the design and use of educational software in the field of anticipating the needs and preparing the requirements of each surgical procedure is recommended to all professors and officials in the operating room field.
Materials and Methods: This study was a semi-experimental intervention study in which 70 operating room students from the 4th, 6th, and 8th semesters of the undergraduate operating room program were selected through a census method and were trained using educational software designed by the researcher. Before and after the training, their clinical skills were assessed using a researcher-made questionnaire and checklist. To confirm the validity of the questionnaires and the researcher-made checklist, the opinion of an expert panel (12 expert faculty members) and the consensus of peer reviewers were used. Then, the data were analyzed in SPSS software using descriptive statistics, paired t-test, nonparametric Wilcoxon test, and analysis of covariance test.
Results: According to the research findings, the use of the designed software was effective on the clinical skills of operating room students. Based on the results of the Willcocson tests, a significant difference was observed in the mean scores of the students’ clinical skills test before and after implementing the designed software. The results of the study showed that the clinical skill scores of the students increased after using the software. The maximum scores of the samples are calculated from 100 points. The average clinical skill score of the subjects in the study increased from 40.98 before the educational intervention to 92.36 after the intervention, and the students had a higher level of skill in preparing the items and tools needed by the surgical team in all three stages before, during, and after surgery. Also, in the study, no relationship was found between any of the demographic variables studied, such as age, gender, and academic semester, and the clinical skills of the study members (P<0/05).
Conclusion: Based on the results of the present study, the design and use of surgical preference card software in training procedure of operating room students has had an impact on improve their clinical skills. Therefore, the design and use of educational software in the field of anticipating the needs and preparing the requirements of each surgical procedure is recommended to all professors and officials in the operating room field.
Pezhman Sadeghi, Nader Jahanmehr, Reza Rabiei,
Volume 19, Issue 5 (12-2025)
Volume 19, Issue 5 (12-2025)
Abstract
Background and Aim: Information systems serve different purposes in organizational and management hierarchies. The hospital intelligent management system is an analytical and decision-support management information system that provides information and important performance indicators for managers in hospitals. Considering the role of this system in increasing the efficiency and effectiveness and the lack of academic hospitals having the desired level of productivity, this research was conducted to investigate the effective factors in improving the acceptance of the intelligent hospital management system in the hospitals of Shahid Beheshti University of Medical Sciences (SBMU).
Materials and Methods: This descriptive and correlational research was conducted in 19 hospitals (12 teaching hospitals and 7 non-teaching hospitals) of Shahid Beheshti University of Medical Sciences in 2022. In this study, 126 senior and middle managers and experts of the productivity committee participated. The data of this study were collected Using the Unified Theory of Acceptance and Use of Technology(UTAUT) Questionnaire and for statistical analysis, SPSS software (statistical table and linear and multiple regression tests, sequencing, and chi-square) was used. The validity of the questionnaire was determined using the opinion of research experts and its reliability was also determined using Cronbach’s alpha coefficient (0.824).
Results: Most of the participants in the study were from teaching hospitals (63.2%) and were middle managers (50.8%). Behavioral intentions were identified as the most important factors in the use of system by senior and middle managers and experts of productivity committee (P<0.001). The effort expectancy had the greatest impact on the intention to use the system as compared to the expected components of Performance expectancy and social influence. Also, training and having educational programs on how to use the HIM and its applications can increase the intention and use of the HIM by employees (P<0.001).
Conclusion: Based on the results, the effect of the moderating variables in this study was insignificant. If senior managers and influential people encourage working with the system, and employees also make more effort to learn the system, and working with the system meets their expectations, employees will be willing to use the system. In other words, employees use the system when they believe that this system is user-friendly, valuable, and useful for them.
Materials and Methods: This descriptive and correlational research was conducted in 19 hospitals (12 teaching hospitals and 7 non-teaching hospitals) of Shahid Beheshti University of Medical Sciences in 2022. In this study, 126 senior and middle managers and experts of the productivity committee participated. The data of this study were collected Using the Unified Theory of Acceptance and Use of Technology(UTAUT) Questionnaire and for statistical analysis, SPSS software (statistical table and linear and multiple regression tests, sequencing, and chi-square) was used. The validity of the questionnaire was determined using the opinion of research experts and its reliability was also determined using Cronbach’s alpha coefficient (0.824).
Results: Most of the participants in the study were from teaching hospitals (63.2%) and were middle managers (50.8%). Behavioral intentions were identified as the most important factors in the use of system by senior and middle managers and experts of productivity committee (P<0.001). The effort expectancy had the greatest impact on the intention to use the system as compared to the expected components of Performance expectancy and social influence. Also, training and having educational programs on how to use the HIM and its applications can increase the intention and use of the HIM by employees (P<0.001).
Conclusion: Based on the results, the effect of the moderating variables in this study was insignificant. If senior managers and influential people encourage working with the system, and employees also make more effort to learn the system, and working with the system meets their expectations, employees will be willing to use the system. In other words, employees use the system when they believe that this system is user-friendly, valuable, and useful for them.
Hojjat Rahmani, Payam Bahadori, Hossein Dargahi, Mohammad Arab, Nasrin Abolhasanbeigi Gallehzan, Mohsen Mardali,
Volume 19, Issue 6 (3-2026)
Volume 19, Issue 6 (3-2026)
Abstract
Background and Aim: The occurrence of conflict of interest in the Iranian health system has a negative impact on the provision of efficient and effective health care and services to patients, the training and education of students in medical sciences. Despite the efforts made in the country’s health system to manage conflict of interest, this phenomenon is currently observed through various factors, including the inefficiency of the financial structure, lack of transparency, and the lack of an integrated health information system in Iran.
Materials and Methods: The present scoping review study that aimed to identify and determine conflict of interest management strategies in the Iranian health system in comparison with selected countries and to select appropriate strategies in 2024-2025 using the Arksey and O’Malley guidelines. All relevant articles and resources from 2007 to 2024 were extracted from national and international databases by observing the entry and exit criteria and by selecting Persian and English keywords. After screening steps using Prisma flowchart, 23 studies in English and Persian language from international and national databases, were analyzed.
Results: Findings from 17 international studies—most of which were conducted in the United States—along with 6 domestic articles, showed main strategies of Iranian conflict of interest which included participation, transparency, legal oversight, processes reform, restructuring and reorganization. Although, using collective campaigns for correction of process behaviors and decisions, definition of ethical ethic codes, and standardization may help implementation of these strategies. Also, the most common cause of conflict of interest in the health system is individual rather than organizational, which requires regulation, the use of legislative levers, and the transparency of financial relations in the health system.
Conclusion: Accurate identification of potential examples of conflict of interests among the agents of health care system by implementing information clarification, and using modern procedures may decrease the challenges in formulating and implementing strategies of conflict of interests among Iranian health care system. Although benchmarking from successful countries will be helpful in these countries. The implementation of these recommendations may face challenges within Iranian society, including resistance from certain professional groups, a lack of financial and technical resources, and the complexity and specific conditions of the health system. Therefore, a step-by-step approach to implementing policy recommendations for managing conflicts of interest in the health system should be considered.
Materials and Methods: The present scoping review study that aimed to identify and determine conflict of interest management strategies in the Iranian health system in comparison with selected countries and to select appropriate strategies in 2024-2025 using the Arksey and O’Malley guidelines. All relevant articles and resources from 2007 to 2024 were extracted from national and international databases by observing the entry and exit criteria and by selecting Persian and English keywords. After screening steps using Prisma flowchart, 23 studies in English and Persian language from international and national databases, were analyzed.
Results: Findings from 17 international studies—most of which were conducted in the United States—along with 6 domestic articles, showed main strategies of Iranian conflict of interest which included participation, transparency, legal oversight, processes reform, restructuring and reorganization. Although, using collective campaigns for correction of process behaviors and decisions, definition of ethical ethic codes, and standardization may help implementation of these strategies. Also, the most common cause of conflict of interest in the health system is individual rather than organizational, which requires regulation, the use of legislative levers, and the transparency of financial relations in the health system.
Conclusion: Accurate identification of potential examples of conflict of interests among the agents of health care system by implementing information clarification, and using modern procedures may decrease the challenges in formulating and implementing strategies of conflict of interests among Iranian health care system. Although benchmarking from successful countries will be helpful in these countries. The implementation of these recommendations may face challenges within Iranian society, including resistance from certain professional groups, a lack of financial and technical resources, and the complexity and specific conditions of the health system. Therefore, a step-by-step approach to implementing policy recommendations for managing conflicts of interest in the health system should be considered.
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