Journal of

Background and Aim: The risk of infectious diseases in laboratory's personnel is high and several factors can increase these risk. Some of these factors are general, such as burning (with stray acid and base) and electric shock hazards. Which are not exclusive for laboratories. In other hand some several risk factors such as burning liquids are exclusive for laboratories. And there is limited information available about them.

Materials and Methods: This cross-sectional study was designed to evaluate accidental exposures of all laboratories personnel of Teaching Hospitals of Tehran University of Medical Sciences during 2004- 2005. We selected 416 laboratories personnel's in 15 different teaching hospitably TUMS for our study. The data were collected using a questionnaire and SPSS software was applied for data analysis.

Results:There was no significant association between accidental exposures with gender (p=0.51), educational level (p=0.11) and age (0.09) of laboratories personnel. But, accidental exposures were lower among those who had job experience between 5 to 10 years (p<0.05) compare to less than 5 years or more than 10 years job experience.

Conclusions:Although age, gender and educational level of laboratories personnel did not influence their exposure to laboratory's accidents, little or extensive job experience may increase accidental exposures among them. 

Background and Aim: General Store department is responsible for on time preparing commodities for hospitals departments. It's a place for saving materials and resources. Safety in store department and its materials has importance due to preserving high quality and continuous services.
General Store department safety should be audited by assessment System to reduce waste materials and human resources such as building, commodities and patient and personnelُ s lives and in case of facing with a problem, try to solve it. The aim of this study was determination of safety standards in hospital general stores in TUMS.

Materials and Methods: This research was conducted as a cross-sectional study safety and usage of management principles was advised and measured in hospitals of TUMS sampling was nُ t performed.

Results: Safety rate in research population was more than 85/42 percent. Score in safety aspects like as physical spaces, preventing robbery, blazing materials appropriate storing, commodities arrangement, utilizing suitable tools was more than 80%. Protection against fire and storing rote able materials estimated 79% and 77%.
Safety rate in several aspects was assessed in the study hospitals.

Discussion and Conclusion: Although, hospital store rooms assessed as safe but they should try to develop fire protection systems and store rote able materials preservation appropriately.

Background and Aim: Because of preventing of radiation damages, special safety issues are considered in radiology departments: But, the other safety aspect issues are not observed regularly. As an important part of safety plan, radiology departments should be assessed from physical, building design aspects and cope with fire.

Materials and Methods: This descriptive study was directed as a cross sectional research. Tehran University of Medical Sciences hospitals radiology department were assessed for standards of physical spaces, radiation preventing, and cope with fire, patient's and staff safety.A Check-list was used as data collection instrument.Each safety issue estimated as safe (>80%), not safe (<50%) and relatively safe (between 50 and 80 %).

Results: Overall, safety standards were observed in Tehran university of Medical Sciences Hospitals Departments,with relatively safe standards regarding patient's safety and cope with fire.

Conclusions: Fire protocols must be regarded in radiology wards in hospitals. Appropriate designing and programming which considers patient's safety from the time of  entering to radiology ward until leaving is offered.

Background and Aim: The operating room is one of the main units in a hospital, where the most important phase of treatment is performed. Due to the physical properties, use of gases, and different electric devices in the operating room, the safety of both the patients and the staff should be considered carefully. This study aims to estimate the safety standards of the operating rooms in ‎Tehran University Hospitals and to provide solutions to the existing problems.

Materials and Methods: This is a descriptive, cross-sectional study conducted in the operating rooms of TUMS hospitals. The research instrument was a checklist used by interviewers while observing the place. The safety standards were studied in terms of physical environment, protection against fire‎, personnel safety, patients' safety, and infection control. The data were analyzed by SPSS software.

Results: The overall safety of the operating rooms of TUMS hospitals was found to be 84.9 percent. The figures for infection control and personnel safety, however, were lower.

Conclusion: The operating rooms of Tehran University of Medical Sciences hospitals were studied in terms of five safety standards. Considering the physical environment, fire protection, and patient safety, they were quite safe but as to infection control they were relatively safe. However, they were found to be unsafe regarding the safety of their staff. Tehran Heart Center with an overall safety of 97.5% for its operating rooms can be considered as a model for the other TUMS treatment centers.

Background and Aim: Hospitals are among the most important establishments providing health services, in which -- due to special hazards -- the observance of safety principles is of great importance. This research aimed to study the safety conditions at educational hospitals of Shiraz University of Medical Sciences(SUMS).

Materials and Methods: This cross-sectional descriptive study was conducted in all educational hospitals in Shiraz and their safety status was investigated using safety audit technique. To this end, audit checklists were prepared and completed through observation, interview with managers and officials of various departments as well as studying the related documents. Then, based on the realization of safety requirements, hospitals were classified into three levels of poor (lower than 50%), medium (5o-75%), and good (higher than75%).

Results: The mean realization of safety requirements in the studied hospitals was 58 percent. The highest and lowest levels of realization of safety requirements were related to radiation safety and safety management, respectively. Safety status was evaluated as poor in 25% and medium in 75% of the studied hospitals.

Conclusion: The safety conditions of the studied hospitals, especially as regards safety management, emergency response plan, and fire safety aspects were relatively poor. The most important reason for that was the lack of clarity of responsibilities and of safety organizational structure. To improve the safety status, hospitals are required to establish the Occupational Health and Safety Management System (OHSAS 18001).

Background and Aim: Clinical laboratories, due to their succeptibility to potential risks, are priorities in all activities concerning safety issues in hospitals.
Total Quality Management (TQM) is a model considered by WHO for clinical laboratories safety development. This study aimed to assess how safety standards were followed at the clinical laboratories of hospitals affiliated with Tehran University of Medical Sciences (TUMS) based on TQM safety regulations.

Materials and Methods: This descriptive study was conducted on a research population including TUMS hospitals clinical laboratories in 2012. For data collection, census was applied and sampling was not considered. The data gathering instrument was a checklist measuring seven safety components based on TQM. The validity of the instrument was determined through content validation, and Cronbach alpha was calculated to be 0.82. For the analysis of the results, descriptive statistics including frequency percentage of scores was employed.

Results: The safety of research population turned out to be suitable in terms of four factors: designing, existence of general safety items, conducting standard safety activities, and safe disposal of laboratory wastes. Besides, implementation of safety programs and increase in employees’ knowledge to cope with accidents were relatively acceptable. The emergency evacuation program, however, was estimated as poor.

Conclusion: The studied laboratories enjoy relatively safe conditions, but imperfect implementation of safety protocols can endanger safety conditions. Therefore, it is necessary to take the required correcting measures to ensure full safety in clinical labs.

 Background and Aim: Patient safety standards are a set of requirements that are crucial for the implementation of patient safety in hospitals. Process evaluation of patient safety in hospitals has developed a mechanism to determine the level of patient safety. This mechanism can also start a program aimed at improving patient safety and evaluate programs that are being used. 

 Materials and Methods: This analytic study was to determine the status of compliance with critical safety standards for patients in 10 hospitals in Tehran in May to August 2013. All segments of the population are hospitals in Tehran and were selected randomizely. Research tool was a checklist and its validity and reliability was approved. SPSS version 16 software for data evaluation and statistical techniques were used.

 Results: According to the data of this study, the mean level of standards was 76.69%. Also, according to the average standards, the highest level of respect in Group D (80.40%) and minimum standards in group B (56.33%) were observed. Hospitals that had more than 400 beds (71.73%) and hospitals with less than 200 beds (66.22%) have been met with standards.

 Conclusion: According to these results, we can increase patient safety standards of our country by establishing the culture of patient safety, patient-centered approach to service delivery, training of staff and patients and legal barriers.

Background and Aim: The analysis of patients’ safety clinical indicators is considered as one of the safety improvement instruments. Therefore, the present study is aimed to analyze the indices of safety clinical services in selected hospitals of Tehran University of Medical Sciences (TUMS).

Materials and Methods: The present descriptive-analytical study was conducted in 11 TUMS hospitals in 2013. The study tool was the patient safety evaluation protocol of the World Health Organization (WHO). A checklist was completed following interviews, observations, and documentation reviews. The data were analyzed with descriptive and analytical tests, and SPSS software version 13.

Results: The average scores of the studied hospitals were 96.6, 85.6 and 66 for the required, basic and advanced indices, respectively. The figure was not acceptable in required standards, but it was acceptable in basic and advanced ones. In the studied hospitals, numbers 7, 2, 4, 11, and 9 enjoyed the highest amount of conformity with standard, and were placed in rank 2 according to the ranking protocol. Finally, there was no meaningful statistical difference among hospitals in their observance of standards.

Conclusion: Conformity with necessary standards was low in 6 studied hospitals, but in 5 hospitals, it was acceptable in basic and advanced standards. Hospitals need enhancement programs in statements of information management system, drugs management system, infection reduction system, and effective clinical system.

Background and Aim: Patient safety is a critical element of health care quality, and is a priority of health system that pursue to improve the quality of health services. This study aims to determine the attitude the nurses about patient safety in hospitals of Tehran University of Medical Sciences.

Materials and Methods: Nurses employed in 7 emergency and intensive care ward specialty and subspecialty hospital affiliated with Tehran University of Medical Sciences was invited to anonymously complete safety attitudes survey. Reliability of the questionnaires was evaluated by calculating Chronbach’s alpha. ANOVA were used to compare the score means between the wards. Spearman correlation test was used to analyze the correlation between the safety dimensions and the outcome variables.

Results: The results showed that the highest score was dedicated to stress recognition, and the lowest score was related to management perception and working conditions. No significant difference was between the perceptions of emergency department nurses and intensive care nurses with various aspects of safety culture in hospitals.

Conclusion: Patient safety status described as acceptable in emergency and intensive care wards. There is a need to understanding of the atmosphere and the culture of safety by hospital executives deeply.

Background and Aim: In health sector, improving quality of treatment services and patient safety are considered as vital. The objective of this study was to determine the relationship between the quality improvement and patient safety (QPS) and the hospital performance indicators. 
Materials and Methods: In this descriptive analysis research, the statistical population included managers, matrons,  one of the members of the quality improvement committee and one of the clinical governance office members of Shahid Beheshti University of  Medical Science teaching hospitals (N=44). In order to evaluate QPS, data were gathered through questionnaire and the hospital performance indicator data were gathered through interview and observation. Also independent T test was used to determine the relationship between the quality improvement and patient safety and performance indicators.
Results: All five areas of (QPS) including leading and planning, designing clinical and managerial processes, collecting the data, analyzing the data and improvement were significant in QPS score and   according to independent T-test, the relationship between (QPS) and bed occupancy percentage, average length of inpatient stay, bed turnover interval, bed turnover rate and gross death rate was significant (p-value<0/05).
Conclusion: Considering (QPS) standards can improve hospital performance indicators.

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