a. a. ebrahimian

It is very important to calculate the costs of inpatient services covered by the global tariff and compare it with the approved tariff in hospitals in regard to the financial profit and loss. In this regard, this study was conducted with the aim of comparing the costs of global inpatient services bills with their approved tariffs in Niknafs Obstetrics and Gynecology Hospital in Rafsanjan.

In this descriptive study, the population included all the invoices of hospitalized cases subjected to the global tariff in 2019 in Niknafs Hospital in Rafsanjan. The required data were collected from the patients' accounts and analyzed using descriptive statistics and SPSS 20 software.

In 2019, out of the total inpatient services related to the obstetrics and gynecology group, 6 services subjected to the global tariffs were performed in Niknafs Obstetrics and Gynecology Hospital in Rafsanjan. A comparison of the average costs incurred in these services with their approved tariffs showed that in all of them, hospital costs were between 10.74% and 20.54% higher than the approved global tariffs. The highest difference (20.54%) was related to cesarean section, and the lowest (10.74%) was related to hysterectomy.

The results of this study showed that the global services of this hospital have no economic justification and global tariffs lead to losses of the hospital. Therefore, it is suggested that hospital officials focus more on managing the costs of global services, and approved tariffs be reviewed in a timely manner, commensurate with the growth of inflation and taking into account the different conditions of patients.

Retraining programs for nurses are usually run as workshops and group discussions causing challenges as limitations on the number of participants، long lasting duration and high costs. Since most of these programs are taught by instructors working outside of clinical setting، it is necessary to use a method to train large groups of nurses in a short time. The purpose of t his study was to determine the effects of lecture-based training delivered by the peer nurse on the EKG interpretation knowledge of critical care nurses.

In this experimental study، two out of seven intensive care units of Semnan University of Medical Sciences were randomly selected as the experimental and control groups with 11 nurses each. Data collection on nurses’ knowledge about electrocardiogram (ECG) interpretation in the experimental and control groups was done through a questionnaire containing 25 questions. Then، one of the nurses in the experimental group who obtained an acceptable score was selected and was considered as a lecturer in the same group after receiving additional training on interpreting ECG. She taught ECG interpretation principles to nurses in one session. After one week، nurses’ knowledge on ECG interpretation in two groups was measured. Data were analyzed using descriptive and inferential statistics.

Significant difference was observed in the total scores and areas of ECG interpretation between pre and post test in the experimental group (P< 0. 01). A significant difference was also found in the mean of changes of mean scores in total scores and areas of ECG interpretation in the same group (P< 0. 01).

Lecture-based training delivered by a colleague can be considered as a cost effective and efficient method for ECG interpretation education; therefore، it is suggested that health care managers concentrate on empowering their personnel and invite them to teach in retraining programs.