Hospital Practices and Research
Volume:8 Issue: 1, Winter 2023

Seeking local evidence on treatment efficacy is necessary if cultural factors are involved, as in psychotherapy for Chronic Pain (CP). Yet, local evidence is known to be prone to bias, making it difficult to reach reliable conclusions.

This study aimed to critically evaluate our local evidence on the efficacy of psychotherapy on quality of life and disability in CP. It has been elaborated that, with some requirements, common meta-analytic tools can be utilized to detect and correct local evidence bias.

The protocol was registered on PROSPERO, Record [deleted for blind review]. Elmnet, Pubmed, and ProQuest were searched for randomized trials. A multilevel meta-analysis was used to capture the hierarchical structure of the data, and robust variance estimation was used for inference. Several moderation analyses were conducted, and publication and other related sources of bias were examined.

Forty-two trials were initially included. Six were excluded before the analysis due to serious reporting problems undermining their validity. The SMD from 185 effect sizes was 1.08 [.87, 1.3]. The funnel plot showed a strong bias. The bias-corrected estimate from a regression-based method was 0.45 [0.04, 0.87], and from the trim-and-fill was 0.75 [0.48, 1.0].

While our original estimate was large, the corrected estimation showed a medium effect, fairly comparable to the international estimates. Current evidence on different sources of bias in our literature suggests low quality and questionable research practice as the first suspects for our local evidence bias.

Management of cardiovascular disease (CVD), the leading cause of death in the world, is often associated with a variety of treatments and lifestyle modifications.

In this review, the authors sought to identify and summarize self-care related behaviors in persons with CVD based on Orem’s self-care theory. By applying this theory, healthcare professionals can involve patients in their own care in a holistic way that can improve health outcomes.

A comprehensive review was conducted using the Web of Science, PubMed, Magiran, SIDS, Scopus, CINAHL, and Google Scholar databases. The results were organized into themes based on the Orem’s Self-care model for patients with CVD.

A total of 1153 articles identified through databases. After excluding duplicated, unavailable or unqualified articles a total of 12 articles met all inclusion criteria and were included in this review and categorized into five major themes based on Orem’s self-care model for patients with cardiovascular diseases: basic conditioning factors and self-care agency, initiating and adhering to self-care activities, symptom recognition, and supportive nursing interventions and culture. The model suggests the patients should take responsibility for self-care behaviors; and nurses, peers, families and health systems can have a great impact on the level of self-care in these people with considering cultural factors.

Improving the well-being in people with cardiovascular diseases and reducing the related healthcare costs are achievable by promoting self-care behaviors based on culture, educational interventions, and monitoring the self-care over time as suggested by the model.

Several studies have been performed to evaluate the efficacy of different pain management techniques in patients with trauma, using different methods.

To compare Intravenous (IV) morphine vs. fentanyl for analgesic response, the time to reach lowest pain score, and adverse effects in patients with trauma who were referred to Emergency Department (ED) was investigated.

This double-blind randomized controlled trial (June-December 2017) was performed on adult traumatic patients, who were referred to the EDs of two main trauma centers (Affiliated to Shiraz University of Medical Sciences), in southern Iran. The inclusion criteria were acute pain >4 on a Numeric Rating Scale (NRS) 0-10 upon presentation. The patients were randomly allocated to receive a single dose of IV morphine (0.1 mg/kg) or IV fentanyl (2 µg/kg). The pain score was recorded at baseline, 5, 10, 30, and 120 minutes after administration of either morphine or fentanyl, as well as adverse effects. Then, the data were analyzed.

In order to carry out this study, 167 patients were enrolled. The initial NRS in both groups were similar. The mean ± SD of NRS at all times was higher in the fentanyl group, except in 10 minutes, but only in 120 minutes, this difference was statistically significant (p= 0.01). The mean ± SD of pain reduction in all times was similar in both groups. The incidence of adverse effects in both groups were not different (p = 0.18).

According to findings, IV fentanyl had a similar analgesic effect to IV morphine in traumatic patients with acute pain. Also, there was no significant difference in terms of adverse effects between groups.

A green hospital is a hospital that improves people's health by continuously reducing environmental consequences and eliminating its harmful effects. Therefore, in recent years, the concept of "green hospital" has been created due to sustainable development with the aim of controlling costs and protecting the environment.

The purpose of this study was to determine and compare the level of compliance with the standards of green hospitals in teaching hospitals in Yazd.

This descriptive-applied study was conducted in 2022. A standard checklist was used to collect data. This checklist included 11 areas and 96 questions. For data analysis, frequency and percentage were used in SPSS26 software.

The level of compliance with the standards of green hospital was 75.88%, the highest score was related to Shahid Dr. Rahnamon Hospital (80.55%) and the lowest score was related to Shohadai Mehrab Hospital (70.13%). The waste water management variable was obtained with 61.3% as a priority for improvement, and the highest score was obtained in the area of hazardous consumables (90.73%).

It seems that the teaching hospitals of Yazd had an average status in the field of environmental protection and controlling costs and pollution as well. Therefore, in order to comply with the standards of green hospital, a comprehensive planning is required regarding the 11 studied areas, so that in addition to focusing on their strengths and improving them, also covering the weaknesses and bringing them to an acceptable level is recommended.

Outbreak detection algorithms could play a key role in public health surveillance. This study aimed to compare the performance of three algorithms (EWMA, Cumulative Sum (CUSUM), and Poisson Regression) using the reported COVID-19 data for outbreak detection. Three outbreak detection algorithms were applied to the data of COVID-19 daily new cases in Iran between 19/02/2020 and 20/06/2022, and 344 simulated outbreak days were injected into the data sequences. The Area Under the Receiver Operating Characteristics (ROC) Curve (AUC) and its 95% confidence intervals (95% CI) were also computed. EWMA9 had the lowest AUC (51%). Among the different algorithms, EWMA9 with λ = 0.9 and CUSUM 1 had the highest sensitivity with 100 and 87% (95% CI: 84%-91%), respectively. According to the results, CUSUM, EWMA, and poison regression showed appropriate performance in detecting the COVID-19 outbreaks. These algorithms can be extremely helpful for health practitioners and policymakers in the detection of infectious disease outbreaks.

 Healthcare workers are in close contact with patients and have serious responsibilities for the health and life of people. Moreover, dissatisfaction of employees with their jobs has a negative impact on the quality of services and ultimately leads to dissatisfaction of patients.

 The present study aimed to investigate the relationship between work engagement and professional ethics with organizational intelligence in healthcare workers through the mediating role of organizational support.

 The statistical population included all healthcare workers of Ahvaz (Iran) in 2022, 137 of whom were selected through convenience sampling. In this descriptive-correlational study, the Pearson correlation coefficient and mean structural equation modeling were employed for data analysis. The research instruments included the Utrecht Work Engagement Scale, the Professional Ethics Questionnaire, the Organizational Intelligence Questionnaire, and the Survey of Perceived Organizational Support.

 According to the findings, there was a positive relationship between professional ethics and organizational support (β = 0.27, P = 0001). There was a positive relationship between organizational intelligence and work engagement in healthcare workers (β = 0.22, P = 0.003).  There was also a direct relationship between organizational intelligence and organizational support (β = 0.51, P = 0.001), and a direct relationship between organizational support and work engagement (β = 0.35, P = 0.001). There was an indirect relationship between professional ethics and work engagement (β = 0.05, P = 0.002) as well as organizational intelligence and work engagement (β = 0.10, P = 0.001) mediated by organizational support.

 The final model had a good fit. The present study's results should be considered an essential step toward identifying the factors affecting the job performance of healthcare workers.

 Hand hygiene has been recognized as an upfront yet a vital practice that halts the transmission of nosocomial contagions or healthcare-associated diseases in hospital locations. In healthcare organizations, hand hygiene is an important component of contagion prevention and protects patients' safety as a low-cost intervention.

 The objective of the present study was to evaluate hand hygiene practices among public health nurses in Trauma and Specialist Hospital and Winneba Municipal Hospital in the Effutu Municipality in the Central Region of Ghana.

 This study employed a quantitative approach with a descriptive cross-sectional design. Structured questionnaires were used to collect data from 100 respondents through simple random sampling technique. Data analysis was done using Statistical Package for Social Sciences (SPSS), version 21.

 Findings revealed a low level of knowledge on hand hygiene (45%) among the respondents and a high hand hygiene practice (79%). Most of the respondents always washed their hands immediately after a risk of body fluid exposure (95%) and few always washed their hands before touching a patient (60%). Most of the respondents always rubbed soap on wet hands before rinsing (78%) and few of them always allowed their hands to dry (16%). The barriers which prevented most of the respondents from washing their hands in the health facility were busy work schedules (65%), forgetfulness (61%), lack of hand hygiene resources in the health facility (38%), minimal patient contact (37%) and lack of knowledge on hand hygiene (13%).

 Respondents in this study exhibited a low level of knowledge on hand hygiene yet, hand hygiene practice among them was found to be somewhat satisfactory. The study recommends that multifaceted and dedicated efforts must be made to rectify the barriers which impede public health nurses from effectively complying with hand hygiene practices in the health facilities.