Journal of

Background and Aim: The main goal of each hospital - like all health care sectors - is protecting and increasing the health level in orsig country. The important role of human resources in hospitals is appropriate strategic decisions making for fast environmental changes and shows the need of staff participation. Nurses as a one of the biggest parts of hospital staff need to participate much more in strategic decision making in hospitals. This article is aimed to measure the level of nurses' participation in strategic decisions making.  

Materials and Methods: This research is descriptive - analytic. Total nurses of Shariati hospital were 577 nurses of which 175 nurses were selected and studied.The gathering information instrument was questionnaire adapted from Dustdar thesis. This questionnaire contained 35,5 - choice questions set by Likert basis. Project's data was analyzed with SPSS software in % 95 confidence levels and statistical specifications like mean, standard error,correlation and non parametric tests were used.

Results: According to the results obtained, there are meaningful relation between staff participation in strategic decision making and: marriage situation (PV=0.01), Decision Directing (PV=0.0), culture of participation (PV=0.00), organization maturity (PV=0.00) and risk tolerance (PV=0.01)  

Conclusions: It has been observed that nurse participation in strategic decision making in Shariati hospital is in "low" position (participation mean score: 28.52 from 100). So an administrator effort for spreading culture of participation to owner's process is something that should be paid attention more than before.

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

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

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

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

Background and Aim: Based on theories and researches, two variables effective in the continuous improvement of services are trust in and identification with hospital goals. The present study aims to explore the relationship between such variables among nursing staff members in private hospitals of Shiraz.

Materials and Methods: This research is a cross-sectional correlation study. Some 340 nurses(58 males and 282 females) were selected using the stratified sampling technique.
Three questionnaires for the assessment of identification with hospital goals, measurement of continuous improvement, and determination of trust in hospital were used. The reliability of data collection devices turned out to be 0.70, 0.70 and 0.79, respectively. Besides, the construct validity was confirmed through factor analysis. Data were analyzed inferentially using Pearson's correlation test and hierarchical regression analysis.

Results: The findings show that the relationship between identification with hospital goals and trust and nurses' effort to improve continuously is positive and significant. Moreover, the results of hierarchical regression analysis show that after controlling gender, age, experience and education, first identification with hospital goals and then trust in hospital play a significant role in the effort to improve continuously.

Conclusion: Nurses' effort to improve continuously is mostly influenced by identification with hospital goals rather than trust in hospital.

 Background and Aim: Information technology acceptance model predicts acceptance based on end-users' perceived usefulness and ease of use of technology for a specific purpose. The aim of this study is to understand nursing staff’s adoption of clinical information systems based on information technology acceptance model.

 Materials and Methods: This descriptive- analytic study was conducted on 316 nurses in hospitals affiliated with Semnan University of Medical Sciences (SUMS) and those affiliated with the Social Security Organization (SSO). The data collection tool was a valid and reliable questionnaire . The d ata were analyzed by descriptive statistics, Mann-Whitney and chi-square tests .

 Results: Some 73 % of nurses agreed that the nursing information system provides them with correct information. Besides, 55.7% of nurses had accepted the information system. The results showed that male nurses had admitted clinical information systems more than female ones (P<0.05). Moreover, nurses who were aware of their duties towards the computer program or those who were aware of the goals of computer applications had adopted information technology more (P <0.05).

 Conclusion : Most of the nurses had accepted the clinical information system in their daily work. However, issues such as inadequate number of computers , content design, system c apability problems, and nurses' computer skills and knowledge should be seriously examined . Moreover, several interventions should be planned and developed in technical and individual areas such as enhancement of nurses' IT knowledge , teamwork culture , organizational position , team cooperation, and updating and upgrading the network.

Background and Aim: If the evaluation is done from the perspective of users, Successful development of measures and features related to use and implementation of hospital information system and identify areas that need further consideration is to be provided. The main purpose of this study was assessment the views of physicians and nurses of hospital information system identify the effective criteria for the use of it and their satisfaction.

Materials and Methods: Present research is a descriptive cross-sectional study and was applied in public- education hospitals of Tehran University of Medical Sciences in 2012- 2013. The main tool was a questionnaire prepared by reviewing relevant literature in databases Iranmedex, Magiran, SID, PubMed, Science direct, Google scholar, and surveys by experts. In order to determine the validity, a questionnaire was distributed among 5 experts in the area of ​​information technology. After completion of the questionnaires, results were analyzed using software SPSS17.

Results: Information systems in half of the hospitals surveyed from the perspective of research community have an average of 30 - 60 percent capabilities in order management. Also users in all surveyed hospitals with more than 43 % agree the ease of using hospital systems.

Conclusion : User satisfaction is a guarantee for the implementation of information system. To improve the situation and move towards the ideal condition we suggest users needs in hospital information systems should be considered. Also design and system should be Compatible with the skills and knowledge of users as possible.

Background and Aim: Learning basic issues in nursing requires new strategies that can enhance knowledge retention among nurses. This study aimed to determine the effect of lecturing by peer-nurses on critical units nurses’ retaining knowledge of electrocardiogram (ECG) interpretation.

Materials and Methods: In this experimental study, two units (as test and control groups) were selected randomly from among critical care units of Semnan University of Medical Sciences hospitals. First, a pretest was performed on nurses in both groups. Then, the nurses of test group were trained by a peer-nurse how to interpret ECGs. A posttest was performed on the two groups both a week and a year later. Finally, the data were analyzed using Pearson’s correlation coefficient, t-paired and t-tests.

Results: The mean of nurses’ scores of ECG interpretation in pretest was 9.55±2.73 in the test group and 10.82±3.43 in the control group. In the first posttest, mean scores of nurses’ knowledge in test and control groups were 15.27±2.57 and 11.36±3.29, respectively. In the second posttest, nurses’ mean scores in test and control groups were 10.82±4.07 and 11.33±2.95, respectively. There was a significant difference (p<0.05) between the pretest and the first posttest in the test group, but there was no such difference for the second posttest (p>0.05).

Conclusion: Lecturing by peer-nurses can enhance nurses’ knowledge about ECG interpretation in the short run, but it cannot enhance knowledge retention. So it is suggested that other educational methods be used in nurses' in-service training programs designed for ECG interpretation.

Background and Aim: Work-family conflict and spillover are among threatening factors in hospital environment for nurses’ well being. The present research aimed to study the relationship of work-family conflict and spillover to affective well being among nurses.

Materials and Methods: The research method was correlational and the statistical population consisted of female nurses of two public hospitals, among whom 197 persons were selected using availability sampling method.­ Data gathering instruments were the previously made questionnaires including work-family conflict questionnaire, work-family spillover questionnaire and affective well being questionnaire. The reliability and validity of the instruments were verified and the data were analyzed using multiple regression analysis. 

Results: The results of regression analysis revealed that work-family conflict had a significant predictive power for the prediction of negative and positive affect. Also, the results of regression analysis revealed that homework spillover had a significant predictive power for the prediction of negative affect and that free time spillover had a significant predictive power for the prediction of positive affect.

Conclusion: The results of the present study showed that work-family conflict and spillover could cause problems to nurses’ affective well being. Therefore, it is necessary that nurses be trained to manage work-family conflict and spillover in a suitable way.

Background and Aim : Nurses' perception of spirituality can affect the way they behave and communicate with patients in line with spiritual care provision. The present study aims to investigate nurses' perception , capability, and adequacy of training about spirituality and spiritual care in Genaveh hospitals affiliated to Bushehr University of Medical Sciences (BUMS) .

Materials and Methods: A cross-sectional descriptive study was performed among 111 nurses working in BUMS hospitals in 2013. The spirituality and spiritual care scale (SSCRS) was used for data collection, which explores nine aspects of spirituality and spiritual care. Descriptive statistics were used to analyze the data. 

Results: The overall spirituality and spiritual care was 3.86 (out of 5). Among the nine aspects of need for spirituality, belief in God had the highest mean score, and beliefs and values had the least mean values. About 78.7 % of the participants were confronted with the patients' spiritual needs. Meanwhile, 74.6 % of them noted that the current training about spiritual care was not sufficient .

Conclusion: Although most participants were able to meet the patients' spiritual needs, most of the nurses did not know enough about the issues related to spiritual care. Therefore, inclusion of spiritual care in nursing curriculum and holding workshops and training courses in this area can be useful.

Background and Aim: Medication errors make up a large portion of medical errors that mostly happen in hospitals. To prevent medication errors, it is essential to reach an appropriate understanding regarding with their causes and reporting especially among nurses. The purpose of this study was to determine the reasons of medication errors and the causes of not error reporting from nurses’ viewpoints. 

Materials and Methods: This is a descriptive analytical cross-sectional study conducted in year 2013. The study population were nurses working in different working shifts in special and sub-special pediatric hospitals in Tehran. A sample of 294 nurses recruited using a stratified non randomized sampling approach. The corrected Gladstone questionnaire with appropriate validity and reliability was used. The data were analyzed by descriptive (frequency, mean and standard deviation) and analytical statistics (Mann-Whitney and Kruskal-Wallis) using SPSS version 16.

Results: The most important reasons of medication errors were tiredness of nurses, wrong dose prescription by the physicians and illegible prescriptions. Fear of the nursing manager's reaction was the main obstacle to reporting medication errors in the view of 74.9% of nurses. The nurses estimated that only 42.52% of all the medicinal errors were reported.

Conclusion: Raising awareness regarding with the types and causes of medication errors and their reporting and implementing the relevant intervention to address these causes should be established in hospitals in particular in pediatrics wards.

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: Nurses’ main tasks include the provision of healthcare services at the highest levels of quality and quantity standards, and based on the findings of scientific research. The aim of the present study is to identify and determine the barriers of evidence-based practice among nurses of Qazvin hospitals, in Iran, at 2013.

Materials and Methods: The present cross-sectional research was a descriptive- analytic study conducted among 260 nurses practicing in six hospitals of Qazvin in 2013. The barriers scale questionnaire developed by Funk, et al. was used to examine the four dimensions of evidence-based practice (EBP) barriers including adopter, organization, innovation and communication characteristics. To analyze the data, descriptive and analytic statistics were used.

Results: The mean score of EBP barriers among subjects was 3.07 out of 4. Among the barriers, "organization" and "adopter" dimensions had the highest and lowest mean scores, respectively. There was no significant statistical relationship between gender and EBP performance, But a significant relationship was observed between organizational dimension with age, employment type and work experience.

Conclusion: Since “organization” was found to be the main  barrier to  the use of research in nursing performance, policy-makers and administrators should pay attention to the use of research in performance, the establishment of a research culture in organization, the creation of appropriate infrastructures, and the allocation of sufficient time to the nursing personnel to have access to evidences.

Background and Aim: Learning is essential in healthcare environments, where knowledge and skills are quickly outdated due to continuous advances in medical science. Organizational learning is a dynamic process that enables learning organizations to be campatible with change in good time. The aim of this study was to determine the status of organizational learning in an Iranian healthcare organization in Tehran, and to assess the extent to which this organization could be considered as a learning organization.

Materials and Methods: In this cross-sectional and descriptive study, 200 nurses were selected in an Iranian healthcare organization. Dimension Learning Organizational Questionnaire (DLOQ) was used to collect data to be analyzed using descriptive statistics methods by frequency, percentage, mean, and standard deviation.

Results: The mean overall score for organizational learning was 3.36±0.69. Among the various dimension of organizational learning, continuous learning had the highest average (3.44±0.39), and the empowerment had lowest amount (2.72±0.06).

Conclusion: The findings from this study provide useful information for these organization's managers regarding the areas where there is a need for improvement in OL and to make it a more LO.

Background and Aim: Due to social development, population growth, industrialization of countries and require some work, most of the employees are working with program shift. The purpose of this study was determination of relationship between nurses shift rotation and personality characteristics and coping strategies in selected private hospitals in Tehran, Iran.
Materials and Methods: In this descriptive and cross-sectional study standard shift work questionnaire and Eysenck personality questionnaire was used. After confirming the validity and reliability (Cronbach's alpha 0.73), the questionnaire was distributed among 305 nurses and 6 non-governmental hospitals in Tehran on the cluster random sampling method. Descriptive and analytical methods were used for data analysis using SPSSv.22 software.
Results: 43.6 percent of nurses participating in the study were introverted and 56.4 percent were extroverted. The results showed that there was a meaningful statistical relationship between age and health (p=0.008), gender and physical health (p=0.015), education level and physical health (p=0.014), gender and physical-cognitive anxiety (p=0.006), age and family- socioeconomic status (p=0.001), marital status and family-socioeconomic status (p=0.001), second occupation and family-socioeconomic status (p=0.001). 
Conclusion: Planning according to nurses working hours standard and to avoid overtime, especially nurses who have more experience can prevent severe complications of shift work and improve health and the quality of care. 

Background and Aim: Conflict, is a natural and inevitable phenomenon in any organization. Nursing organizations, especially due to environmental stresses, nature of work, variety of interaction, responsibilities and staff are vulnerable to conflict. The purpose of this study was to determine the level of conflict, cause of conflict and conflict management strategies among nurses in selected hospitals of Tehran University of Medical Sciences (TUMS) in 2013.
Materials and Methods: This research is cross-sectional and descriptive - analytic study. The research sample included 240 nurses at four hospitals of Tehran University of Medical Sciences. In order to measure conflict level dubrins conflict level questionnaire and for measure conflict management Robins conflict management strategies were used, for survey to accept or reject the study hypothesis, Chi-square and Fisher's exact tests with SPSS software was performed.
Results: Results showed that the nurse's conflict level was located at average level. Factors relating nurse practitioner frequent cause of conflict, identified strategies of conflict management were solution orientation, non-intervention, control, In the present study  conflict level had showed significant statistical relation with age of nurses (p=0.048). 
Control strategy had showed significant statistical relation with age (p=0.006) and work experience (p=0.024). Solving oriented strategy had showed significant statistical relation with age (p=0.02).
Conclusion: Conflict is a two-dimensional phenomenon, conflict can be both positive and negative results, how to deal with conflict, it is crucial for consequences.