فصلنامه آموزش و اخلاق در پرستاری
سال ششم شماره 3 (پاییز و زمستان 1396)

With increasing rate of incurable disease and advances in medical technology and therapies in the other in the recent years, facing health care team members with many ethical challenges. One of these challenges is euthanasia. The aim of present study was investigation of specialist’s physician and medical students’ viewpoints about euthanasia.

Present descriptive - cross sectional study performed in Hajar & Kashani teaching health centers in Shahrekord in 2014. 143 (65 specialist physician and 78 medical students) participated in this study. Data were collected with use of demographic form and Euthanasia Attitude Scale (EAS). This scale has 21 item that distributed in four categories include; ethical consideration, practical consideration, treasuring life and naturalistic belief. Data were analyzed with use of SPSS 15.

The mean age of physicians was 43.12±5.32 and The mean of student’s age was 25.56±0.98. The majority of physicians (87.3%) and medical students(62.8%) have negative attitude to euthanasia. There was indirect statistical correlation between students age and attitude to euthanasia (P<0.02; r= - 0/236)and significant difference between students with different religion belief (p<0.001). But there was not significant relationship between demographic parameter and attitude of physicians to euthanasia.

Results of present study showed that majority of physicians and medical students have negative attitude to euthanasia. That seems in line with religion, belief and culture in Iran.

Providing resources to meet all health and medical needs in the health sector is not totally realized even in wealthy countries. Hence, the issue of resource allocation and prioritization has always been one of the management challenges in health systems.
Patient The patient was a 63-year-old man who taken to the hospital because of a reduced level of consciousness. In the ambulance, the patient had a heart attack and received electric shock due to ventricular fibrillation (VF). Immediately after admission to the hospital, he was hospitalized in the intensive care unit (ICU). After two days, the patient's consciousness was still low and his pupil showed a slight reaction to light. A few hours later, the patient suffered a seizure and the CT Scan results indicated hypoxic brain damage. Despite medical and special care efforts, he has remained in the same situation in the ICU and no improvement has been found. It is 22 days that he has been in the hospital. Recently, an 18-year-old patient has been taken to the hospital due to a stroke in a car accident. However, there is no blank capacity of ICU in other wards of the hospital and we face a shortage of ICU beds. Through the establishment of the hospital ethics committee, review of indications, and involvement of the 62-year-old patient’s fellows in decision-making, one bed can be added to one of the wards and the necessary ICU services can be provided to the patient with a higher emergency status. Another suggestion is that an extra bed can be added to the ICU in order to keep both patients in this ward. In this case, considering the resource constraints, the quality of serving all patients will similarly reduce from the standard level.
Keywords: Prioritization; Resource allocation; ICU bed; Medical ethics

in the past decade,significant progress has occurred in order to improve patient safety But still there are several shortcomings and the amount of damage on patients from the adverse effects is high unacceptably So one of the most important goals of health care organizations is assess, improve the quality of health care and increase patient safety Therefore,this study has done to examine the degree of Observance of the WHO Surgical Safety Checklist in jahrom of teaching hospitals.

This is cross-sectional study that is performed on all of the anesthesia and operating room nurses in educational hospitals of Jahrom University of Medical Sciences in 2016. Instrument of data collection in this research were"demographic information and Surgical Safety Checklist"of the World Health Organization in 2009.

In this study,46/2percent of participants were anesthesia nurse and 53/8 percent were operating room nurse.The average age of participants in this study were(31/06±6/16).the Degree of Observance of the WHO Surgical Safety Checklist in anesthesia nurses was(14/27 ±1/57)and in operating room nurses was(14/76±1/96)and overall was(79/1±53/14).A significant relationship was not observed between demographic variables and Degree of Observance of the WHO Surgical Safety Checklist(p> 0/05).

considering the role and importance of Surgical Safety Checklist in increased patient safety,research should be conducted in order to identify obstacles Observance Surgical Safety Checklist To be able to take steps to resolve deficiencies and improve the safety surgery of patients.

Researches in recent decades have suggested that paying attention to the spiritual dimension, including privacy and personal realm, is a requirement that gives the elderly an indescribable place in peace, vigor and vitality. Spiritual interventions have a significant impact on the process of healing and respecting the privacy of patients is among the dimensions of spiritual care. This is especially important in the elderly. This study was designed to determine the relationship between attitudes to spirituality and spiritual care in order to respect the privacy of the elderly in nursing and surgical wards of hospitals in Zahedan University of Medical Sciences in 2013-2014.

This was a descriptive cross-sectional study of the community-based research sample, and included all of the nurses and surgical wards of hospitals in Zahedan Medical Sciences University respectively (Hospital Ali Khatam hospitals), respectively. Data gathering tool was a researcher-made, valid and reliable questionnaire for respecting the privacy in the elderly. Spirituality and spiritual care tool (SSCRS McSherry) was completed by nursing staff and data were analyzed using descriptive and inferential tests and software SPSS16.

The results showed that the mean and standard deviation of privacy compliance in the elderly is 106/5 ± 13/8 and the attitude toward spirituality and spiritual care is 57.64 ± 7/1, which is relatively high. There was no correlation between the two variables Privacy. There was no statistical relationship between the two variables. There was a significant relationship between age and privacy (p <0.05), so that with an increase in age, the privacy score was reduced. The privacy of elderly women is more than that of men.

The results showed that nurses are not paying enough attention to the privacy of the elderly. With increasing age, the respect the privacy lowers. Because spiritual care is one of the dimensions of recovery, the health and well-being of the patients, therefore, it is essential to pay more attention to this important issue, including privacy.

Nursing professional values, guiding actions that are necessary for development of nursing profession. It can used as a basis for decision-making in professional nursing procedures. However, there is limited research about this matter in Iran. Therefore, the present study was conducted with the aim of observance of professional values in the clinical nurses.

In this cross-sectional study, 260 nurses who working in hospitals affiliated to Kerman University of Medical Sciences were selected using stratified random sampling method. Data were collected using a two-part questionnaire that included demographic variables and Nursing Professional Values Scale - Revised (NPVS-R) questionnaire ,with the reliability and validity 0.92 of the tool. Data were analyzed using descriptive (mean and standard deviation) and analytic statistical tests (Mann-Whitney, Kruskal-Wallis) using SPSS software version 19.

 The total average score of nurses' professional values was 102.70±16.64 and the highest mean score was allocated to each of the dimensions of care (4.21±0.48), justice (4.13±1.37), trust (4.11±0.82), professionalism (3.80±0.95) and activism(3.52±0.70) .There was a statistically significant difference between the mean scores of the employment status and type of ward with total mean score of professional values, however, there was no significant relationship with other variables (significant level p <0.05).

According to the results, the status of nurses is nearly favorable for professional values. therefore, activities for internalization and promotion of nursing professional values is necessary.

One of the most important resources of any organization, its human resources. Constitutive elements of the force, people feel that if they have sufficient motivation, talent and skills are at the service organization. Having morale and job satisfaction is very important to achieve high productivity of organizations. The aim of this study was the effect of organizational climate and quality of work life and job compatibility is the Ardabil city in 1395.

The sample of 274 nurses were Ardebil city were selected randomly. Tools Organizational Climate questionnaire, a questionnaire quality of working life and career compatibility.

The results showed that the barley innovative, collaborative environment, growth opportunities, rules, overall living space and coherence in the job compatibility with a significance level of less than 0/05 and there is a significant positive relationship.

Organizations need to have a particular atmosphere and environment of the organization, because, as was a positive atmosphere in the organization has destructive effects, positive atmosphere for the underlying organizational potential of individuals. In other words, hospitals are able to increase our desire to increase people's willingness cooperative atmosphere and by encouraging collaboration and innovation to benefit from its positive effects. And also by improving the working conditions increase the quality of life.

Accuracy, skill and adherence to medical ethics are the minimum expectations of the patient from the treatment staff. And failure to do so will cause financial and economic loss to the patient. Negligence means something that should be done for the patient, but that was not the case at all. The purpose of this ethical report is to outline the issue of carelessness and negligence in treatment and care through the introduction of a case of medical-care failure in a patient admitted to Intensive Care Unit.

A 48-year-old man was a farmer (a combine driver) who suffered from severe hemorrhage of arterial hypoxia, followed by coma for 6 months. To maintain the airway, a tracheostomy tube was used to feed the nasal tube to the gut (NGT). Regarding the condition of the coma and despite the restriction of use of the gastrointestinal tract (max. 4 weeks), the patient was discharged after 50 days with a tracheostomy tube and gastric nasal congestion and consciousness level (4 out of 15). This led to multiple physical problems and persistent complications for the patient (after healing) and multiple treatment costs for the patient's family.

The position of the doctors and the curative staff makes the seemingly small negligence cause great consequences for patients and their families. Indifference and negligence for patients with coma and low levels of consciousness is very unpleasant.