Zahra Meidani, Mehrdad Farzandipour, Hamidreza Gilasi, Manizheh Shekrachi, Zahra Nazemibidgoli,
Volume 10, Issue 4 (9-2016)
Abstract
Background and Aim: In attention to hospital beds serves as an invaluable resource in health system and necessity for appropriate hospital beds utilization through the reduction of patient inappropriate stay, this study aimed to assess the proportion and causes for hospital inappropriate stays.
Materials and Methods: The proportion and causes for hospital inappropriate stays were analyzed in a cross-sectional survey using a sample of 1925 days of hospital stay based on the Appropriateness Evaluation Protocol. The study was conducted at the tertiary care University Hospital Shahid Beheshti, 510 – bed teaching hospital which is located in the central part of Iran.
Results: Hundred and twenty one days (6.3%) of 1925 days of patient hospitalization were inappropriate. There was relationship between inappropriate stay and patients’ age and types of insurance. Findings relating to analysis of patient non demographic causes revealed that among hospitals, physicians and patient causes, Hospital-related causes and Physicians related causes have the most impact 42 (33.1%) and 37 (29.1%) on patient inappropriate stay respectively.
Conclusion: AEP list of reasons provides base line data for performance improvement in health care organizations. For conducting improvement process, developing a multidisciplinary team under title of Utilization Review committee is recommended to pave the way for targeted interventions based on identified potential causes.
Soraya Sayar, Sara Noruzi, Seyed Mohammad Hossein Javadi, Mohammad Sabzi Khoshnami, Sanaz Dehghani, Maryam Pour Hosein, Mahnaz Zamyadi,
Volume 17, Issue 6 (2-2024)
Abstract
Background and Aim: Considering the role of social workers in the health system, the success and stability of organ transplantation, prevention of re-hospitalization of patients and reduction of imposed costs, this study aims to design a protocol for the specialized interventions of social workers in Iran’s medical centers in the transplant process and to create uniformity in practice. Comprehensive services have been provided to patients and their caregivers.
Materials and Methods: The study was conducted in two phases of resource review and qualitative. In the resource review phase, reliable databases were examined, and in the qualitative phase, in order to collect information from Delphi techniques and focused group discussion with the presence of fifteen officials and social workers working in the country’s hospitals and experts and experts. The areas of health and treatment assistants of the Ministry of Health, university professors, medical staff and experts in the field of transplantation and organ donation were carried out. The protocol was sent to eight experienced experts for final review and evaluation, and they were asked to review the protocol in terms of the goal and scope of interventions, stakeholders, development steps, clarity of presentation, accessibility and non-dependence in writing according to the checklist to evaluate.
Results: In this study, the work process of social workers was drawn in three stages before, during and after transplantation. Also, various roles were considered for social workers in three stages of work, including the role of defender, supporter, case manager, resource mobilizer, trainer, consultant, evaluator and guidance. Interventions such as finding informational support, facilitating the patient hospitalization process, providing psychosocial support to the family with the aim of empowering them for post-transplant care, providing counseling to family members to deal with stress and improving mental health of the patient, providing economic support, Accomodation conditions are provided through hospital companions and communication and interaction with the treatment team, including the doctor, in order to respond to the needs of the family, facilitate treatment and on time discharging.
Conclusion: the protocol of specialized interventions of social workers in the transplantation process created a new step and a different look at psychosocial support in transplantation and coordination teams, so that social workers in the field of organ donation and transplantation and working with caregivers, families and the survivors of the patients arrived.
Sedigheh Hannani, Parsa Farmahin Farahany, Fardin Amiri,
Volume 18, Issue 3 (5-2024)
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.
