HOSPITAL
Year:2017 | Volume:16 | Issue:3 (62)|Papers Count:13

Background: One of the main goals of health sector evolution plan is reducing the amount of out of pocket payment by patients receiving hospital services in public sectors. This study aimed to assess the amount of out of pocket payment by inpatients in public hospitals affiliated to Shahid Beheshti University of Medical Science in Tehran city in 2015.Materials and Methods: In this cross-sectional study, 405 discharged patients from four public and teaching hospitals were selected using convenient sampling method. Data were collected using a researcher made checklist and investigating the hospital bills. In order to data analysis, descriptive statistics and regression analysis were utilized through SPSS Software version16.Results: The amount of out of pocket payment was 10.2 percent included 9.9 percent formal payment, 0.2 percent bought & brought goods and 0.1 percent informal payment. The most portion of the hospital costs was related to medical supplies and pharmaceuticals, surgeries services and hosteling with 32.6, 20.6 and 17.36, respectively. Type of hospital, having surgery, average length of stay, family size and gender had significant effect on the out of pocket payment amount (p£0.05).Conclusion: The amount of out of pocket payment by inpatient in public hospitals was in accordance with goal of the health sector evolution plan, which reveals the appropriate government support. It is recommended to tailor and implement enormous plans regarding outpatients and private sector in national level to attain sustained reduction in out of pocket payment.

Background: Equitable and suitable access of all citizens to the urban public service is one of the primary principles of urban planning, which with the rise of the justice-centered approaches in recent decades has been double care. In the meantime, access to health services as one of the vital public service has greater sensitivity. This research has been performed with aim of identify enjoyed and nonenjoyed regions regarding health care and its distribution assessment applications in Tabriz city.Materials and Methods: For the access analysis ARC GIS software, specially Network Analysis tool and Williamson and entropy index and has been utilized. Also, considering respective per capita, Tabriz city population needs and the existing deficiencies have been specified.Results: The study results indicate that %76 of Tabriz city population have optimal access to healthcare facilities. In contrast, in the analysis of access to hospitals %36 of population have optimal access to theme and %64 have Undesirable access. Also, in urban zones analyses unit, based on Williamson index analysis, the index was calculated 0.67 to Tabriz city, which indicates an imbalance in the distribution of health care Facilities in the Tabriz city.Conclusion: In general, zone 2 has the most balanced distribution of health care facilities and zone 9 is suffering from imbalanced distribution of health care facilities. It is suggested that in order to reduce the inequalities in the enjoyment of health care facilities, proper assessment about to existing facilities and future planning, in terms of Threshold, capacity and access should be conducted.

Background: This study was conducted to validate the "staff attitude toward the use of coercion in the treatment of mentally ill patients" questionnaire and assessed their attitude in selected public psychiatric hospitals in Tehran city.Materials and Methods: This is a descriptive and analytical study which was carried out on three hospitals of Tehran University of Medical Sciences, Iran University of Medical Sciences and social welfare and Rehabilitation University in 2015. The questionnaires were distributed to the participants and finally 273 questionnaires were used. Data were analyzed using confirmatory factor analysis test.Moreover, ANOVA and independent t-test were applied to evaluate the participants' attitude on using coercion for treatment of mentally ill patients.Results: Study findings revealed that 61% of participants were nurse and 11% were physicians.According to the study results, three final obtained factors explained 61.93% of the total variance; this variance reflects the proper and appropriate selection of the questions. In addition, there were statistically significant differences between marital status and offending attitude domain; between job and education and offending attitude; and security and treatment domains.Conclusion: The current questionnaire has a high validity and reliability and is also appropriate for the context of Iran. The attitude of the studied participants was a bit towards using coercion in treatment of mentally ill patients. Therefore, it is recommended that authorities take some steps toward changing health services providers' attitude of using coercion.

Background: Accreditation is an appropriate strategy for improving the quality, safety and effectiveness of hospital services. Iran national hospital accreditation was initiated as a government and mandatory program in 2012. This study aimed to identify the prerequisites of hospital accreditation implementation in Tehran province hospitals.Materials and Methods: This qualitative study was performed using semi-structured interviews with 72 managers in different level from 15 university, private, military, social security and charity hospitals in 2016. Hospitals were selected purposefully through Tehran province hospitals. Content analysis was used in order to data analysis.Results: Pilot testing of standards before announcing to hospitals for implementation, education and training of hospital managers and employees on accreditation standards, providing required resources, allocating enough time for implementing the standards and providing incentives for implementing standards are the main hospital accreditation prerequisites. Absence of these prerequisites in accreditation implementation resulted in huge challenges for hospital managers and employees.Conclusion: Providing the accreditation prerequisites for hospitals facilitates implementation of hospital accreditation in hospitals which in turn results in quality improvement, safety and hospital services effectiveness.

Background: Reduction of errors is necessary to improve the quality of healthcare, promoting communication between the hospital staff and patients, and decreasing the patient's complaints in hospitals. Due to the high probability of error in the operating room (OR), this study aimed to detect the potential errors in the OR of Nemazee hospital using FMEA.Materials and Methods: This study was a qualitative one which assessed Failure Mode and effects of OR in six steps using FMEA technique. At First, the OR activities were listed, then the failure modes were recognized. Next, the Risk Priority Number (RPN) of each error was calculated according to the indicators of Occurrence (O), Severity (S) and Detectability (D).Results: Totally, 204 failure modes in 36 activities in five process in surgery ward were recognized.15.7 percent of failure modes classified as high risk factors (RPN³ 100). The most and the least distribution of origin factors were related to human and organization and technical errors, respectively.Conclusion: The majority of errors in OR was set in of human skills category. Besides, the most and the least failure modes were belonged to “patient anesthesia by circular activity number 20, RPN=1795.23) ” and “not to oxygenation for patients (the activity number 36, RPN=99.33) respectively. Identification of 36 activities and 204 errors in the 5 processes of Operating Room represents the comprehensiveness of HFMEA method in the identification, classification, evaluation and analysis of the health system errors.

Background: Personnel training and development of readiness are important to attain individuals to personal and orgnazational purposes (job career) and Mentor/ coach quality performance is crucial in this regard. The sensitivity of this issue can be in the spotlight in hospitals. The present study aims to examine relationship between emotional intelligence, job satisfaction, perceived organizational commitment and justice with mentoring performance in hospitals personnel.Materials and Methods: The present research was a cross-sectional one which study population included all of physicians, nurses, radiology and administrative staff and service workers of Poursina public Hospital in Rasht. Four hundred and three individuals were selected by quota sampling and responded to demographic information, emotional intelligence, organizational justice, job satisfaction, organizational commitment and mentoring function questionnaire. data was analyzed using SPSS software version 20.Results: hierarchical regression analyses with enter method revealed that each three component of Organizational Justice, namely distributive justice, interactional justice, procedural justice could explain significantly 60% shared variance results of Mentoring function of one component of job satisfaction specifically Supervisor Satisfaction, and one component of emotional intelligence specifically self-management (F=26.18, P<0.0001).Conclusion: The employees' perceptions of organizational justice, supervisor satisfaction and also the ability of people to control emotions and appropriate reactivity in different situations is related to quality of Mentor/ coach function in hospital. According to the obtained results and effective variable on Mentoring, it is recommended to make decisions for hospital/manageral interventions related to emotional intelligence, organizational justice and job satisfaction.

Background: Job stress is a part of physician, nurses and hospital executives lives. Medical is tense basicly and tension affects the quality of life and health of physician. This study aimed to determine the occupational stress and its relates factors among medical residents in Kurdistan University of Medical Sciences.Materials and Methods: In a cross-sectional study, all of seventy-one medical residents of Kurdistan University of Medical Sciences (first to fourth of residency in 2012) in the field of internal medicine, obstetrics and gynecology, pediatrics and psychiatry were recruited in the study. Data collection was performed using standard questionnaire of job stress, Osipow. In the descriptive analysis, mean, standard deviation (SD) and range were determined for quantitative variables. For hypothesis analysis t-test and chi-square were used.Results: Mean age and SD was 32.3±3.05 years. Thirty-nine of participants (54.9%) were female and 32 (45.1%) male respectively. Job stress was moderate to severe and low to moderate in 80.3% and 19.7% participants respectively. Average job stress score were almost th same in different scales. But, stress in responsibility subscale was more than the others. Gender, specialty field and all subscales of job stressors had significant relationship with Job stress (P<0.05). But age, marital status and years of residency were not associated with job stress (P>0.05).Conclusion: As the majority of medical residents experiencie moderate stress, providing interventions in residency training programs management in order to reduce the stress in Kurdistan University of Medical Sciences seems necessary.

Background: One of the main principles in comprehensive care giving in nursing is spirituality and spiritual care which has been addressed to have a crucial role in providing more effective treatment in patients. This study aimed to assess nurses’ attitude toward spirituality and spiritual care in hospitals affiliated to Shahid Sadoughi University of Medical Sciences in 2016.Materials and Methods: This descriptive, cross-sectional study was conducted among 133 nurses employed in three selected teaching hospitals affiliated to Shahid Sadoughi University of Medical Sciences in 2016. Data collection was performed through a two- section standard SSCRS questionnaire (The Spirituality and Spiritual Care Rating Scale) including spirituality (n=15 items) and spirituality care (n=8 items). To data analyze SPSS software version 22 was utilized. Significance level was set less than 0.05.Results: The mean score of attitude toward spirituality and spiritual care were calculated relatively 31.15±7.89 and 21.05±5.5, respectively. Furthermore, there was a significant statistical association between nurses’ attitude with gender (p=0.01) and job category (p=0.03). given that, there was no significant association between age, educational level, employment and marital status.Conclusion: Based on study findings, attitude toward spirituality were more desirable compare to spiritual care among nurses. Thus, more training and awareness can have affecting effects on clinical care and treatment quality potentially in spite of positive attitude toward spirituality.

Background: Health of hospital staff has a determinant role in increased productivity and since the main mission of hospitals is community health promotion, in order to achieve this important issue, monitoring, maintaining and improving general health is essential; this study developed to assess general health of staff affiliated to Tehran University of Medical Sciences and identify its related factors.Materials and Methods: This Cross-Sectional, Descriptive-analytical study was conducted among 320 staff members of the Tehran University of Medical Sciences who selected using random sampling.In order to data collection, the General Health questionnaire was used. Collected data were analyzed using SPSS software through t-test and ANOVA tests.Results: Study findings revealed that 47.5% of participants had psychological disorders suspiciously; prevalence of physical symptoms, anxiety, social dysfunction and depression were 53.9%, 49.3%, 79.5% and 14.6% respectively. There was a significant relation between general health and demographic features such as gender, marital status, major, job department, housing situation and type of employment (p<0.05). Also, the personal characteristics of managers influenced on the general health staff.Conclusion: General Health of staff in hospitals Tehran University of Medical Sciences in comparison with similar studies at inside and abroad is not in good condition, therefore, it is recommended that policy makers and managers concerned the programs and solutions towards priorities in order to promote health personnel.

Background: This study aimed to determine the role of core self-evaluation and job autonomy on nurses' job performance in Sanandaj public hospitals.Materials and Methods: This study was a descriptive and correlational one. The study population consisted of the nurses who work in Sanandaj city public hospitals, selected 213 people using stratified random sampling in 2016. In order to data gathering, Paterson job performance scale (1990), Judje et al. core self-evaluation scale (2003) and Gunster job autonomy (1989) were used. Pearson correlation coefficient, regression analysis and multivariate variance analysis (MANOVA) were performed to data analysis.Results: Study results revealed that mean score and SD of core self-evaluation, job autonomy and job performance were 43.84 ± 5.52, 42.65 ± 10.26 and 52.81 ± 5.85 respectively. So that, mean of core self-evaluation and job performance were desirable and job autonomy was at the intermediate level.Also, there was a significant association between core self-evaluation and nurses' performance which this variable was able to predict 15% of job performance variance. While, there was no significant association between job autonomy and nurses' job performance. Also, the study results revealed that there was a significant difference between core self-evaluation and job performance among male and female nurses.Conclusion: Based on study results, core self-evaluation has a significant association with job performance which can predict it among nurses.