فهرست مطالب

  • Volume:2 Issue: 2, 2014
  • تاریخ انتشار: 1392/12/15
  • تعداد عناوین: 8
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  • Ramin Mehrdad, Nazanin Izadi, Gholamreza Pouryaghoub Pages 55-60
    Background And Objectives
    Job satisfaction is a critical factor in attracting and retaining nurses. Although many studies have dealt with nurses’ job satisfaction, rapid transformation of the community and health systems can alter the factors influencing this issue, hence calling for continuous monitoring of job satisfaction as perceived by nurses. Built on this necessity, the present study was conducted to identify factors contributing to job satisfaction of the nurses in an Iranian health system context.
    Method
    A cross-sectional survey among 530 nurses was conducted in Shariati teaching hospital in Tehran. Minnesota Satisfaction Questionnaire was used to measure job satisfaction. T-test was used to compare job satisfaction between nurse groups of different age and work experience. Chi-square test was used to compare nurse groups of different sex, level of education and job status. Correlation of job satisfaction in nurses with their age, gender, work experience, job status, and level of education was examined using logistic regression analysis.
    Findings
    A total of 424 nurses completed the questionnaires (response rate = 80%). Of the total respondents, 47.9% expressed satisfaction with their job. The highest satisfaction score was related to moral values (87.9%) followed by social services (76.1%). The lowest satisfaction score was obtained by compensations (91.8%) followed by professional advancement (84.1%). No significant difference in job satisfaction was found between demographic groups. In addition, no correlation was identified between job satisfaction in nurses and their age, gender, work experience, job status, and level of education. Our study also descriptively showed that nurses were mostly satisfied with intrinsic factors of their jobs when compared with the corresponding extrinsic factors.
    Conclusions
    From a descriptive point of view, improving payments and offering opportunities for advancement are the prioritized factors in improving job satisfaction among the nurses. Lack of relationship between job satisfaction and conventional demographic and professional variables would indicate the changing nature of factors affecting job satisfaction among nurses, calling for further theoretical and empirical studies.
    Keywords: Nurse, Job satisfaction, Hospital
  • Jafar Soleimanpour, Ali Tabrizi*, Mehdi Eskandari, Asghar Elmi Pages 61-63
    Background And Objectives
    Hand hygiene is a crucial measure for preventing healthcare-related infections. Surgical scrub is an important factor in the safety and success of a surgical operation. The aim of this study was to comparatively evaluate effectiveness of some conventional surgical antiseptic solutions, and to identify the most effective one.
    Methods
    Effectiveness of alcohol-based solutions including Mono Rapid, Sterillium, and Desderman was compared with each other and with povidone-iodine (10% Betadine Scrub). Two rounds of sampling were conducted, one before wearing surgical gloves, and the other after removing the gloves upon completion of surgical operation. Colonies were counted after 48 hours of aerobic incubation at 37°C. All counts were conducted twice. Positive cultures were identified and their frequencies were compared. Data were summarized using descriptive statistical methods. Comparison of counts between groups was performed using Chi-square test. Mean values were compared using ANOVA.
    Findings
    From the 157 obtained samples, 50 (30.9%) were positive cultures. A significant difference in the frequency of positive cultures was identified between four surgical scrub solutions (df = 3, χ2 = 17.4, P = 0.001). The lowest frequency of positive culture (7.5%) was observed for the solution containing povidone-iodine (10% Betadine Scrub).
    Conclusions
    Based on our findings, povidone-iodine has a higher antiseptic effectiveness as compared with alcohol-based solutions.
    Keywords: Povidone, iodine, Surgical Scrub, Alcohol, based Solutions, Hygiene
  • Mehdi Barzegar, Elham Afzal, Mohammadreza Maleki, Soheila Koochakyazdi Page 65
    Background And Objectives
    Evidence increasingly highlights the impact of emotional intelligence in managers on the productivity and performance of their organizations. Given the importance of decision-making in the management process, this study explored the relationship between emotional intelligence and decision-making quality in hospital managers.
    Methods
    A cross-sectional questionnaire-based survey was conducted on 30 senior and junior hospital managers. The results were summarized using descriptive statistical methods. Pearson correlation coefficient and multivariate regression analysis were employed to examine the influence of emotional intelligence on quality of decision making.
    Findings
    A significant correlation between managers’ emotional intelligence and their quality of decision-making was identified (r = 0.40, P < 0.001). In addition, multivariate regression analysis indicated that solution finding by the hospital managers is influenced by their emotional intelligence (β = 0.72, P < 0.001).
    Conclusions
    This study provided further evidence for the impact of emotional intelligence on quality of decision-making. Given that emotional intelligence is an acquirable skill, our results encourage hospital administrators to improve managers’ emotional intelligence to achieve a higher organizational performance in health settings.
    Keywords: Emotional Intelligence, decision, making, Hospital, Management
  • Maryam Attari Page 71
    Background And Objectives
    Despite increasing attention toward the employee empowerment, there is little data on cognitive and psychological processes increasing, predicting, and determining the employee empowerment and the organizational variables affecting this construct, particularly in the healthcare context. To help bridging this gap, this study examined the impact of transformational leadership on psychological empowerment of nursing staff.
    Methods
    In a questionnaire-based study, all the nurses of a multi-specialty health facility, Moheb Hospital, were surveyed. Standard questionnaire of Hancott on transformational leadership and Spreitzer’s questionnaire on Psychological empowerment were used to develop the relevant survey instruments. The internal consistency reliability of the survey instruments was examined using Cronbach's alpha. Structural equation modeling was used to test the study hypotheses.
    Findings
    Our results showed the strong impact of transformational leadership on nurse psychological empowerment and its dimensions, including ‘meaning’, ‘competence’, ‘self-determination’, and ‘impact’.
    Conclusions
    Our study recommends that hospital administrators develop transformational leadership skills by getting relevant training and promote such skills in intermediate supervisors, particularly head nurses, to psychologically empower the nursing staff, thereby achieving higher patient satisfaction and hospital performance.
    Keywords: Transformational Leadership, Psychological empowerment, Nurse, Hospital, Performance
  • Pejman Shadpour, Babak Teimourpour, Rouhangiz Asadi Page 77
    Background And Objectives
    Active presence of hospitals on the Internet is becoming a hallmark of hospitals’ commitment to quality healthcare services delivery. For insightful planning towards a strong Internet-based information delivery and communication, there is a need for continuous monitoring of hospital website’s status. Built on this need, this paper provides, for the first time, a ranking of a large number of Iranian hospital websites based on standard webometric methods.
    Methods
    The study targeted ranking of all hospitals affiliated with the Iranian Ministry of Health and Medical Education. Name and URLs of the hospitals were obtained from the official website of the Ministry and then updated using web search, when needed. Hospital websites with un-standard URLs and extremely limited content were excluded from the study, and the remaining websites were analyzed and ranked according to webomeric measures.
    Findings
    A ranking list of 93 hospitals was obtained. The three top-rank websites belong to the hospitals affiliated with Tehran University of Medical Sciences followed by websites of hospitals of Beheshti and Shiraz universities of medical sciences. The top 20 websites belong to hospitals affiliated with only seven medical universities among 17 surveyed. The size, visibility, and richness of hospital websites showed significant intercorrelations (P < 0.001). In addition, regression analysis identified significant linear relationship between hospital websites’ visibility and size (β = 0.6, P < 0.001). On the other extreme, websites of most hospitals affiliated with Babol, Ahwaz, and Hamedan, and Birjand universities of medical sciences constitute the lowest 10 rank group. While these low rank hospital websites slightly differ in size, they share an identical rank (the lowest among) all in terms of visibility and richness.
    Conclusions
    This obtained ranking list of the hospitals can help hospital administrators to evaluate the strength of their on-line presence and plan to improve their status on the web. The fact that the top 20 and the lowest 10 rank hospital websites cluster into a few medical universities highlights the importance of support from holding universities for strong presence of their affiliated hospitals on the web. In addition, identification of significant positive relationship between size and visibility of hospital websites encourages hospital administrators to synergistically improve their webometric rank by increasing the size of their websites.
    Keywords: Webometrics, Hospital, Web, Website, Information, Communication Technology, Internet, Ranking
  • Nader Tavakoli, Ali Reza Taherizade, Ali Tahmasbi, Miladamini, Nasim Ghafurian Page 85
    Background And Objectives
    Patient readmission is an important criterion in performance evaluation of healthcare settings. Identifying the causes of the readmissions would help the policymakers in designing strategies for efficient management of health facilities. This stud aimed to explore factors contributing to readmission by sampling from an Iranian hospital.
    Methods
    Clinical records of 385 patients who had at least one readmission in the hospital during the period of four months were reviewed, retrospectively. Patients’ demographic data, physicians’ information, and the factors related to readmission were extracted from the clinical records. Common factors contributing to readmission were identified by literature review and were grouped into five major categories. Chi-square test was used to determine the relationship between the nominal variables.
    Findings
    The main cause of patient readmission was found to be medical checkup (37.2%), followed by disease complications (15.9%) and surgery complications (12.2%). Moreover, frequency distribution of readmissions were significantly different concerning the background variables including insurance coverage, duration of hospitalization, sex, place of residence, and way of discharge. Furthermore, the frequencies of the five reasons of patient readmission were significantly related to sex, insurance coverage, duration of hospitalization, nature of treatment, and type of discharge were identified. No significant relationship was found between patients’ place of residence and readmission causes.
    Conclusions
    The fact that readmission rate is influenced by multiple factors highlights the need for development of systems approaches to alleviating the rate of unnecessary readmission of patient to health facilities.
    Keywords: Hospitalization, Hospital, Readmission, Patient, Performance
  • Mohsen Mazidi, Bahareh Imani, Abdolreza Norouzy Page 91
    Background And Objectives
    Guillain-Barre´ Syndrome (GBS) is an acute-onset, monophasic, immune-mediated polyneuropathy that often follows an antecedent infection. Special nutritional support has an important role in these patients.
    Methods
    A 6 years old girl with GBS was admitted to NICU of Dr. Sheikh Children Hospital (Tehran, Iran). Chief compliance for hospitalization was inability to walk and having a progressive muscle involvement of the lower extremities upwards. The patient was affected to this condition during just one day before hospitalization. After the patient was stabilized, she was referred to nutritional support team for specialized Guillain-Barre medical nutritional therapy. The patient was discharged after 37 days and had improved medical condition.
    Findings
    From the 157 obtained samples, 50 (30.9%) were positive cultures. A significant difference in the frequency of positive cultures was identified between four surgical scrub solutions (df = 3, χ2 = 17.4, P = 0.001). The lowest frequency of positive culture (7.5%) was observed for the solution containing povidone-iodine (10% Betadine Scrub).
    Conclusions
    GBS is rare; however, it must be considered in the differential diagnosis of any patient, who presents with progressive weakness. It is important to recognize the variety and severity of the neurologic symptoms associated with GBS, especially with the diagnostic difficulties associated with the pediatric population.
    Keywords: Diet, Guillain, Barre´ Syndrome (GBS), Nutrition Support
  • Masoud Etemadian, Pejman Shadpour, Mohammad Javad Soleimani, Mahmoud Biglar, Mohammad Hadi Radfar*, Mahmoud Jarrahi Page 95
    Regarding the fiscal constraints and management difficulties of public hospitals, several countries have used public private partnership model to improve their health facilities. Public private partnership enables using public resources and private investment and expertise in a combined structure. Moheb hospital is the first Iranian hospital managed according to public private-partnership. The private wing of this partnership is Moheb Medical Institute which is built upon a combination of previously existing models i.e. the “design, build, finance, and operate” model as well as the co-location model. Since the hospital and all its properties are endowed by Moheb Institute through an Islamic tradition (Vaghf) to all Iranian people (not necessarily government), Moheb model can be introduced as an Iranian-Islamic extension of public-private partnership model. In this model people are also a wing of partnership. Thus, it should actually be considered as a public-private-people partnership. This experience reveals that this model could be an efficient solution to some of the healthcare system difficulties, provided that it is based on a precise plan designed by skillful managers.
    Keywords: Public Private Partnership, Hospital management