mohammad hosseinikasnavieh

Having weakness and lethargy and feeling the need for hospital emergency services is one of the most important reasons for patients to go to hospital emergency rooms. The aim of the present study was to investigate the relationship between morbidity and mortality of patients with weakness and lethargy.

The present study was conducted in an observational and prospective manner in the emergency department of Rasool Akram and Firouzgar hospitals. The patients were divided into 5 groups by the evaluation team in the emergency triage unit using the international valid triage tool "Emergency Severity Index (ESI)". The patients were followed up for 2 months after the time of discharge and the patient's condition was examined in terms of illness, health or death.

Between levels 1 and 2 (patients with high severity conditions) and 3 (patient needs two or more emergency facilities in case of no disturbance in vital signs), level 3 had the highest frequency of referrals (61.9%). 90.7% had an underlying disease and 66.1% of the patients were taking medication at the time of visit. 11% of patients died in the first visit. In the initial follow-up, 23.7% of people were still sick, 40.7% had recovered and 17.8% had died.

According to results in the final follow-up, 3.9% of people were still sick; the rate of recovered patients in the final follow-up was 44.1% and the percentage of deaths in the final follow-up was 24.6%. The high mortality rate indicates that the patients' concern was not due to weakness and lethargy, but due to a dangerous underlying disease that forced them to go to the hospital.

Two items of the Health Transformation Plan have been specifically related to increasing the quality of visit and Hoteling services. So far, no study has examined the effect of the Health Transformation Plan on the perceived quality of hospital services in Kermanshah. This study was performed with the aim of investigating the relationship between the Health Transformation Plan and the quality of health services.

This is a descriptive study and examines the 22 areas of perception and expectation of patients from the services provided in hospitals in Kermanshah using SERVQUAL model. Significance of the relationship between the Health Transformation Plan and each of the quality variables has been determined using an appropriate test. Data analysis was performed using descriptive statistics, t-test (to test hypotheses), and Friedman test (to rank each of the factors related to service quality components). Analyzes were performed in SPSS software.

283 people (mean age: 37.7 years) participated in the study. The negative gap between patients' perceptions and expectations before and after the Health Transformation Plan indicates that patients' perception was that the quality of services was poor; but this gap has narrowed since the implementation of the Health Transformation Plan. In Imam Reza Hospital, among the quality indicators, assurance (3.61 and P = 0.001) ranked the highest and tangible factors (2.50 and P = 0.001) ranked the lowest. In Farabi Hospital, responsiveness quality indicators (3.38 and P = 0.001) ranked the highest and tangible factors (2.61 and P = 0.001) ranked the lowest. The results obtained using t-test show that the Health Transformation Plan has had a significant effect on all dimensions of quality.  

Although the Health Transformation Plan did not completely eliminate dissatisfaction, it reduced its extent and improved the quality perceived by individuals; therefore, changes in the way health services are provided can still improve people's perceived quality and increase their satisfaction.

Hospitals should be able to satisfy their clients’ needs in less time and with best quality possible. Length of Stay (LOS) in hospitals is considered as a key performance indicator, especially in emergency departments. In this study, the analysis of LOS in emergency departments was performed so that some of the factors affecting patients’ length of stay could be found.
This descriptive-analytical and cross-sectional study was performed in the emergency departments of two teaching hospitals of Tehran University of Medical Sciences (TUMS). Seventy-two patient samples were included. The patients’ length of stay in emergency ward was measured from the entrance time until the time they left the emergency department. Data on both descriptive (mean and standard deviation) and analytical statistics (one-way ANOVA, independent sample t-test and linear regression) were analyzed with SPSS software.
Patients’ average LOS in emergency departments was estimated at around 3 hours and 13 minutes (SD=1.52). Such variables as patients’ marital status, days of the week (holidays or regular days) and admission time (day or night) were determined as the factors affecting LOS.
The time spent to give services in hospital emergency rooms is at an appropriate level and items such as marital status, holidays of a week, and time of the day can be referred to as factors affecting patients’ length of stay. With regard to these findings, health managers can rely on the results for the effective planning and management of hospital emergency departments.

Local anesthetic injections are widely used in the emergency department for different purposes. Pain management for such injections is of great importance to both patients and the healthcare system..
Our study aimed to determine the effectiveness and safety of cryotherapy in patients receiving local anesthetic injections..
Subjects who presented with superficial lacerations were randomly assigned to 2 groups, the first group received ice packing prior to injection and the second did not. The pain severity, length and depth of the laceration, and the other necessary information before and after the pain-reducing intervention were measured, documented, and compared at the end of the study. Pain scores were measured using a numerical rating scale before and after the procedure, and the differences were compared using a t-test..
Ninety subjects were enrolled in the study, 45 in each group. There were no statistical differences between the 2 groups in terms of baseline preoperative and operative characteristics (P > 0.05). The pain scores in the cryotherapy group were significantly lower before and after the procedure (P Cooling the injection site prior to local anesthetic injection is an effective and inexpensive method to reduce the pain and discomfort caused by the injection..