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Hospital Practices and Research - Volume:2 Issue: 2, Spring 2017

Hospital Practices and Research
Volume:2 Issue: 2, Spring 2017

  • تاریخ انتشار: 1396/04/17
  • تعداد عناوین: 8
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  • Sogand Tourani Pages 27-28
  • Greta Falavigna, Roberto Ippoliti Pages 29-35
    Background
    Clinical research is a specific phase of the production process in the pharmaceutical industry in which companies test candidate drugs on patients in order to collect clinical evidence about safety and effectiveness.
    Objective
    This paper is an operational research which aimed to support the hypothesis that pharmaceutical clinical research is like any other production process which could be localized where the cost is most competitive. In other words, this work aimed to demonstrate that the localization process of this specific phase of the pharmaceutical industry’s R&D is based on the price of clinical evidence.
    Methods
    Considering Europe and taking panel data into account, an efficiency frontier through data envelopment analysis (DEA) was estimated. The efficiency of countries in maximizing the number of innovative medical treatments, given their available resources was estimated. Afterwards, focusing on European macro-regions, authors analyzed whether a significant concentration of clinical research exists.
    Results
    Results suggest that, taking the expected principal investigators’ fee into account, Southeastern Europe and Central Eastern Europe are the most attractive macro-regions for the pharmaceutical industry’s foreign direct investments in clinical research.
    Conclusion
    The results of the proposed operational research cannot reject the suggested evolution of the pharmaceutical industry’s clinical research. In other words, results confirm the localization process of the testing phase in East Europe, where the expected principal investigators’ fee is more competitive.
    Keywords: Clinical research, Pharmaceutical industry, Medical institution
  • Mojtaba Ghavidel, Hamid Javadzadeh, Mohsen Saberi Isfeedvajani, Maryam Emami Meybodi Pages 36-40
    Background
    Evaluating and monitoring the performance of emergency departments (EDs) are steps in one of the most important processes to improving the efficiency of hospitals. Indicators such as patient wait time until being visited by a doctor, patient wait time from the order until admission, percentage of patients with a determined order, time of conversion of a patient’s condition, time of physical exit of discharged patients from ED, percentage of discharge with personal responsibility, and percentage of unsuccessful cardiopulmonary resuscitation (CPR) have been used for this measurement.
    Objective
    The current study compared performance indicators in Baqiyatallah Hospital from December 2011 to June 2015.
    Methods
    For this cross-sectional, retrospective study, the study population contained completed checklists of performance indicators in Baqiyatallah Hospital’s ED from December 2011 to June 2015. Five indicators were selected and analyzed using SPSS software and χ2 and analysis of variance (ANOVA) tests.
    Results
    The mean ED performance indicators showed that 71.72% ± 13.29 of patients were determined within 6 hours, 57.53% ± 27.54 were discharged within 12 hours of ED admission, 63.36% ± 12.74 had unsuccessful CPR, 4.57% ± 0.84 left the ED with personal responsibility, mean duration of triage level 1 was 1 minute ± 0.55, mean duration of triage level 2 was 2.83 minutes ± 0.48, mean duration of triage level 3 was 8.58 ± 13.09 minutes, mean duration of triage level 4 was 19.24 minutes ± 13.24, and mean duration of triage level 5 was 40.53 minutes ± 11.66. Statistical analysis of the results showed significant differences in all indicators.
    Conclusion
    The general performance of the Baqiyatallah Hospital ED was estimated to be favorable, and the general process of change during the study was positive compared to previous years; however, the level and quality of services can be increased through some proposed means.
    Keywords: Cardiopulmonary resuscitation, Performance index, Indicators, reagents, Triage
  • Zeynep Ozsoy, Dilek Ekici Pages 41-46
    Background
    The organizational culture, justice, and ethical practices found in nursing services and health services have numerical superiority and a significant importance.
    Objective
    This descriptive study aimed to determine the relationship among ethical behavior, organizational justice and culture in public and private hospitals.
    Methods
    One hundred fifty-three nurses working for at least 6 months in a private or public hospital in Ankara participated in this study. The questionnaire used in this study consisted of three parts: participant demographic data, the ethical leadership scale, and organizational justice.
    Results
    The perceptions regarding organizational culture and ethical behavior of nurses working in a private hospital were found to be greater than those of nurses working in a public hospital. A statistically significant relationship was found between the nurses’ perceptions of organizational culture and justice. A similar relationship between perceptions of nurses regarding organizational culture and ethical behavior was also noted. The results showed that organizational culture explained 30% of the ethical leadership behavior of managers and 35% of organizational justice.
    Conclusion
    The perceptions of nurses regarding justice and ethical behaviors are significantly affected by their work culture exposed in the case of increasing of non-ethic and non-fair behaviours it was the nurses perceive more strength and role culture.
    Keywords: Organizational culture, Justice, Ethics, Behavior, Nurses
  • Chih-Yi Chi, Hsin-Hung Wu, Chih-Hsuan Huang, Yii-Ching Lee Pages 47-53
    Background
    The issues of patient safety and healthcare quality have become increasingly important around the world since the 1990s. Many hospitals manage to reduce the number of adverse events (AEs) that can threaten patient safety in healthcare organizations. Assessing the existing patient safety culture gives hospital management a clear vision of an organization’s strengths and weaknesses. The Safety Attitudes Questionnaire, with its good psychometric properties and great internal consistency, has been used extensively to assess the patient safety culture in healthcare organizations.
    Objective
    Physicians and nurses form the core staff of each organization. With different demographic variables, they might perceive patient safety culture differently. This study purposed to identify critical demographic variables from the viewpoints of physicians and nurses that significantly influence the patient safety culture in a regional teaching hospital in Taiwan.
    Methods
    Linear regression with forward selection was employed in this study to focus on all physicians and nurses using results of a 2015 internal survey in the case hospital. Ten demographic variables were the independent variables, and seven dimensions of the Chinese version of the Safety Attitudes Questionnaire were dependent variables.
    Results
    Four out of 10 demographic variables had significant impacts on 6 out of 7 dimensions (with the exception of emotional exhaustion) from the Safety Attitudes Questionnaire. “Supervisor/manager” and “experience in position” followed by “age” were viewed by physicians and nurses as the most critical variables affecting the patient safety culture in this regional teaching hospital in Taiwan.
    Conclusion
    Assessing an organization’s current patient safety culture provides a significant value to improving patient safety. This study revealed that “supervisor/manager” and “experience in position” are the 2 most important demographic variables influencing the patient safety culture. Hospital management should take heed of the suggestions of staff members regarding these characteristics to continuously enhance their patient safety culture.
    Keywords: Patient Safety, Linear Regression, Physicians, Nurses
  • Hamidreza Torabi Pages 54-55
    Introduction
    Because of bilateral involvement in many cases with diabetic macular edema, Intravitreal bevacizumab injection perform in both eyes. There are some reports of therapeutic effects in the fellow eye after monocular injection of anti-vascular endothelial growth factors. In this study we describe a case of bilateral improvement of diabetic macular edema following unilateral intravitreal bevacizumab injection.
    Case Presentation
    We report a patient with bilateral non-proliferative diabetic retinopathy and diabetic macular edema. Central macular thickness was 398µ in the right eye and 337µ in the left eye. Two months after intravitreal injection of 1.25mg bevacizumab in the right eye, significant improvement of diabetic macular edema was happened in both eyes including the left eye without intravitral injection. Central macular thickness was 245µ in the right eye and 250µ in the left eye.
    Conclusion
    Unilateral injection of intravitreal bevacizumab may have therapeutic effects in the fellow untreated eye. Therefore; unilateral injection in bilateral cases may reduce the costs and complications of bilateral injection.
    Keywords: Bevacizumab, Macular edema, Diabetic retinopathy, Optical coherence tomography
  • Shahram Manoochehry, Hamid Reza Rasouli Page 56
  • Sedigheh Mirhashemi, Mohammad Hosein Kalantar Motamedi, Amir Hossein Mirhashemi, Shaban Mehrvarz, Zahra Danial Page 57