مجله بیمارستان
سال پانزدهم شماره 1 (بهار 1395)

Background Medication administration is an important part of care process. Because of the significant effects on patients’ health, the proper conduct of the medication administration and align it with standards are essential. So, this study was designed and carried out to investigate the Medication administration process by “clinical audit”.
Materials & Methods This study is a cross sectional study which carried out with “clinical audit” and in a hospital in Tabriz in 2014. This audit was conducted in 6 steps including: 1) choose topic of the clinical audit, 2) determine the criteria and standards, 3) check the current status, 4) compare the current situation with standards, 5) design and implement the intervention and 6) Re-audit. Observation method and checklist were used to assess the process and validity of this checklist was approved by experts.
Results The results of this study show that average accordance with standards, before intervention, was 47 percent and the accordance was very low (less than 15 percent) for 11 steps, from 25 steps of Medication administration process. However, after the intervention, the average compliance rate rose to 78 percent.
Conclusion The results indicate an overall improvement in the medication administration process. Despite improvement made, continues assessment and intervention is necessary for continuous quality improvement.

Nowadays, managers should develop working conditions that attracts new nurses, retains the current nurses and prevents from their absenteeism. The aim of this study is determining the contributory factors of sickness absence among nurses of clinical wards in general hospitals of Tehran University of Medical Sciences.
It was an descriptive-analytical and cross-sectional study. The sample size was 400 nurses of clinical wards in general hospitals of Tehran University of Medical Sciences. The instrument was the questionnaire preparing in 100 questions and 2 sections: demographic characteristics (13 questions) and contributory factors of sickness absence (organizational-directorial factors in 49 questions, physical factors in 16 questions and mental factors in 22 questions). The absenteeism criterion was determined based on Rajbhandary and Basu' definition (2010). It was total numbers of days that they didnt present at ward/hospital due to sickness. It was retrospectively gathered from nurse's records. Reliability and validity were confirmed by professors and 20-sample pilot study, respectively. The Cronbach's alpha was calculated 0.79. It was analyzed by descriptive statistics, simple and multiple linear regression by SPSS.
The mean and SD of age was 44.97±5.910. 73.8% were women. Explaining power of predicting factors was very well (F=71.121, P It is necessary to eliminate multiplier factors and fortify pollinator factors of sickness absence. Because it leads into more expenditure, much as it randomly occurs.

Medical errors and adverse events are the main reasons of many avoidable deaths and imposed expenditures in worldwide health systems. Hence, this study aimed to recognize some challenges, medical errors and adverse events, and to address the appropriate solutions to solve them in the Iranian health system.
This qualitative study had three main resources of data including key informants, national documents and expert panel. Key informants (30 persons) and experts ( 12 persons) were selected purposefully from macro, meso and micro levels of health system and some other health related organizations. Data were interpreted and analyzed through a mixed (inductive/deductive) thematic framework.
Findings: Although most reasons of medical error were in relation with weak patient security system and low level security culture in hospitals, other factors like manpower and, physical and out of hospital environment agents induced these errors, too. Identification of medical error reasons in different levels of heath system, documentation of errors and generation a consolidated system for recognition and following the errors and their main causes are the most considerable solutions for decreasing the medical errors in the country.
Removing the reasons of medical errors and adverse events can be a great step for preventing them. It is necessary to eliminate the medical error related challenges and to develop the consonant programs in national level via conclusive will of organizations, groups and individuals.

suitable allocate of budget to the activities of every organization can clarify the distribution of resources, enable to monitor the operational and also expected to provide access to the results of cost. The aim of this study was to calculate the cost of final units in an armed hospital.
One of the Armed Forces Hospital in2013 elected as a study environment. Data to calculate the costs gathered from all cost centers and based on the theory of activity-based costing analysis was performed. Normal and special admission wards, operating rooms, dental and dialysis was considered as final units. To calculate the cost software Excel 2007 was used.
•Total cost of hospital was 244,416 million rails. Direct (52%) and indirect costs were (48%), respectively. The CCU, surgery, ICU and operating rooms had the highest and clinics and dental had the lowest in case of costs. More than 50 percent of the direct costs of all the units have been spent on manpower except the operating room. After labor, drug costs accounted for the largest percentage of direct spending units.
attention to the number and distribution of human resources required units, especially in the final units, and also the use of drugs especially in middle units and consumables, especially in overhead units, can be reduced and adjusted hospital costs.

Considering the importance of hand hygiene in the prevention of nosocomial infections and conducted research indicating that hand hygiene is low, this study aimed to investigate Factors affecting on hand hygiene of nursing and midwifery staff in Hamadan Atea hyspital based on planned behavior model in 2015
This study was a cross-sectional descriptive study, all nursing and midwifery staff of the Atea hospital selected through census sampling. hand hygiene were been observed and all participating answered to planned behavior model questionnaire. In analyzing the data, were used of descriptive and inferential statistics.
Of the 154 people studied, 31 (21/1%), hand hygiene was higher than average and 123 (79/9%) lower than average and hand hygiene after contact with patient environment (21/3%) and prior to action aseptic (13%)were the lowest. knowledge (84%) and attitude (90/4%) workers to perform hand hygiene was high, but the level of perceived control personnel, (53/35%) was at a low level and between perceived control and hand hygiene also between norms subjective and hand hygiene were a significant difference. (p The knowledge and attitude to perform hand hygiene alone is not enough and the training, staff with management , physicians and creating the enabling environment and removing obstacles to the practical hand hygiene behavior is necessary. Key words:Nosocomial infections, Hand hygiene,Planned behavior model

The purpose of this research, is determining relationship between emotional intelligence and occupational stress among the nurses of alzahra hospital (Isfahan). This research of goal aspect, applied and of style aspect is descriptive-surveying. The statistical population consist of nurses in alzahra hospital. They were reportd 960 persons and amount of samples with use by Cochran formula calculated 247. And persons selected by simple accident sampling. The collecting information tools are two questionnaire, emotional intelligence questionnaire (sybershring) with final coefficient 0/85 and Health and Safety Institution of England (HSE) questionnaire with final coefficient 0/84. In order to analyse the data , the comparative t test, pierson correlation are applied. Findings showed that the stress level among the nurses and it’s measuring scales like expectations, control, management support, colleague’s support and role, ranked more than average and the interrelation rank is less than average. Emotional intelligence level of nurses and scales like self-awarness and self-regulation ranked average empathy, self-motivation and social skills ranked less than average. The results showed that is a meaningful relation in p≤0/05 level between the emotional intelligence level and stress in nurses and as the emotional intelligence level increases, the occupational stress in nurses decreases. Thus, The nurses with emotional intelligence go throw less stress which leads to an increase in their performance, Hence, Better quality service for patients.

Given that Tabriz Shohada hospital is the place of accepting emergency patients includes accident victims, Nurses at this hospital are exposed to double stress. This study explored prediction of nursing stress according to personality traits and job engagement in Tabriz Shohada hospital nurses.
The current study was conducted in correlational context. Randomly selected 105 nurses from Tabriz Shohada hospital sections such as sixth general sections, Rehabilitation, ICU & Emergency Department took part in this research. Participants answered to Nursing Stress Scale, Eysenck Personality Questionnaire Revised (EPQ-R) and Job Engagement Scale. Data were analyzed using stepwise multiple regression analysis.
The results indicate that nursing stress is more strongly associated with the neuroticism and there are no relationships among nursing stress and extraversion or psychoticism. Also, nursing stress showed a positive relationship with job engagement. Using the multivariate regression analysis, results indicated that the neuroticism trait & job engagement were suitable predictors towards Nursing stress, of the three personality factors and job engagement.
Nursing stress influenced by internal factors than demographic variables, and two important predictive variables (neuroticism trait & job engagement) have more important role in predicting of nursing stress.

The Status Employment of Medical Librarians in Hospital Libraries of Tehran City Nowadays, it is essential to employ medical and clinical librarians in hospital libraries, to provide the necessary information for healthcare professionals and to help them access evidence based information. Thus, in this study we investigated the occupational status of experts in the field of medical librarianship and information science in hospital libraries of Tehran city in 2013.
This is a descriptive and cross-sectional study, conducted on 152 hospitals in Tehran City. We used a questionnaire to collect the data. Descriptive statistics and SPSS version 18 was used to analyse the data.
Findings indicated that only 13 participants had a degree in the field of medical librarianship and information science, while 28 persons had a degree in librarianship and information science and other participants had a degree in other fields. The majority of participants (51.3 %) with non-related fields to librarianship had learned some librarianship skills in their own experience. Other participants had learned librarianship skills with other methods. Most participants were employed with hiring process followed by the recommendation of friends and relatives, respectively.
There is a lack of medical librarians in the hospital libraries of Tehran city. Thus, these libraries are not able to perform their professional duties that is meeting the information needs of healthcare professionals in hospitals. For the effective and proactive management of medical information resources, hospitals’ managers should try to overcome common hiring obstacles of medical librarians.

Informative Web site's hospital is suitable system for exchanging between patients, hospital and health professional and attracting consumers by hospitals was done. This study aimed with determining quality indicator's hospital websites was conducted.
A literature review study was done by searching in different databases (ProQuest, Ovid, science direct, Scopus, google scholar, PMC, PubMed) and Persian electronic databases (such as; Iranmedex¡Magiran ¡ SID, Iran.doc), by keywords; quality, hospital website, which full text of articles, between 2001-2014, were reviewed. The selection criteria are the subject of articles about quality websites hospital and other health-related Web sites and 85 related articles were found and According to the requirements and criteria of article 45 were used.
with reviewing, The indicators found in the literature, could be included: Alexa rank, google page rank, type of website, technical content of website, information and Facilities of hospital, medical and admission service, online interactive services, research scientific activities, accessibility, speed of website, Comprehensive plan of website, Protect user's personal data, the language of website, User satisfaction, website map, The possibility to navigating in hospital website, Email of Website, Impartiality.
today, with regarding to importance quality of hospital websites and addressing to bio- tourism, the aim is hospital websites should be efficient, accessible, useful, credible, and accessible.

Introduction Employee’s creativity influences quantity and quality of services and affects employees motivation and organizational productivity. This study aimed to examine the relationship between employees’ creativity and managers’ leadership style in Qazvin hospitals.
Methods A survey questionnaire was used for conducting such a descriptive and cross-sectional study. The questionnaire was distributed among hospital employees and managers based on stratified sampling method. Descriptive and analytical methods were used for data analysis using SPSS software.
Results The mean score of hospital employees’ creativity score was 47.5 out of 60 (moderate level). The prevalent leadership style of managers was transformational. There was a meaningful statistical relationship between employees’ creativity and managers’ leadership styles.
Conclusion Hospital managers influence employees’ creativity through their leadership styles. Therefore, they have to apply the right leadership behaviors to motivate employees and develop further their creativity. Key words Creativity, leadership style, employees, managers, hospitals