فهرست مطالب

  • Volume:2 Issue: 4, 2014
  • تاریخ انتشار: 1393/02/14
  • تعداد عناوین: 8
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  • Toktam Khatibi, Mohammad Mehdi Sepehri *, Pejman Shadpour Pages 163-170
    Background And Objectives

    Identification of surgical instruments in laparoscopic video images has several biomedical applications. While several methods have been proposed for accurate detection of surgical instruments, the accuracy of these methods is still challenged high complexity of the laparoscopic video images. This paper introduces a Surgical Instrument Detection Framework (SIDF) for accurate identification of surgical instruments in complex laparoscopic video frames.

    Methods

    Based on the Generalized Near-Set Theory, a novel image segmentation algorithm, termed Generalized Near-Set Theory-based Image Segmentation Algorithm (GNSTISA) was developed. According to SIDF, first GNSTISA is executed to segment the laparoscopic images. Next, the segments generated by GNSTISA are filtered based on their color and texture. The remaining segments would then indicate surgical instruments.

    Findings

    Using the laparoscopic videos of varicocele surgeries obtained from Hasheminezhad Kidney Center, the performance of GNSTISA was compared with previous image segmentation methods. The results showed that GNSTISA outperforms the earlier algorithms in term of accurate segmentation of laparoscopic images. Moreover, the accuracy of SIDF in identifying the surgical instruments was found superior to that of other methods.

    Conclusions

    SIDF eliminates the limitations of previous image segmentation methods, and can be used for precise identification of surgical instrument detection.

    Keywords: Laparoscopy, Surgical instrument detection, Image segmentation, Generalized Near, set Theory
  • Ali Kebriaei *, Meysam Rakhshaninejad, Zahra Afshari, Mohamadreza Mohseni Pages 171-176
    Background And Objectives
    Quality services delivery in the health settings is contingent on hospital administrative staff organizational commitment. Inspired by previous research indicating the prominent role of psychological empowerment in organizational commitment, this study aimed to explore the relationship between the two variables in hospital administrative staff.
    Methods
    A random sample of 172 administrative staff in Khatam-ol-Anbia Hospital at Zahedan city, situated in South-Eastern Iran, was selected. Mishra and Spreitzer’s scale was used to measure psychological empowerment, which comprises 15 items grouped into five dimensions, including Meaningfulness, Competence, Self-determination, Impact, and Confidence. Organizational commitment was measure, using a short version of the Meyer and Allen’s scale. The participants responded anonymously to the items of the two questionnaires. Correlations analysis, t-test, and simple and multiple regressions were used to analyze the data.
    Findings
    Significant positive correlations were found between psychological empowerment and its dimensions as perceived by hospital administrative staff and their perceived organizational commitment. Psychological empowerment was found to be a significant predictor of organizational commitment (β = 0.724, P < 0.001). In addition, among all dimensions of psychological empowerment, Impact (β = 0.474, P < 0.001) and Selfdetermination (β = 0.301, P = 0.001) significantly predicted the organizational commitment, together explaining 51.9% of the variance in the latter variable.
    Conclusions
    Our results extend the established relationship between psychological empowerment and organizational commitment to the hospital administrative staff. In particular, the significant influence of Impact and Self-determination on organizational commitment implies that administrative staff’s organizational commitment will increase if they are given the adequate autonomy to make decision about the work processes. Psychological empowerment can only partially explain organizational commitment variance in hospital administrative staff suggesting existence of other influencing factor remaining to be explored. The fact that Impact shows a stronger effect on organizational commitment supports the notion that the extent to which administrative employees feel a sense of influence on the work processes and outcomes would be the most important factor affecting their organizational commitment. Our findings can help hospital administrators in developing strategies aimed at promoting their organizational commitment via psychological empowerment.
    Keywords: Psychological Empowerment, Organizational Commitment, Hospital Administrative Staff, Hospital Management, Hospital Performance, Healthcare Services Delivery, Healthcare Workers, Human resources
  • Pages 177-186
    Background And Objectives
    While social network analysis has left a remarkable practical impact in the healthcare field, the potential implication of this methodology in the primary health domain is poorly researched. Hence, this study aimed to explore the use and usefulness social network analysis in the context of primary health care.
    Methods
    The health volunteers of Imam Ali Health Center in Isfahan city (situated in Central Iran) participated in a plan aimed at helping prevention of depression in 20-45-year-old mothers. Each health volunteer was asked to choose 5 to 20 individuals from the population they covered. Data were collected using a questionnaire in which each health volunteer determined which other volunteers they interacted, and what direction and frequency each interaction represented, during administration of the plan. An interaction was defined as the exchange of information related to the plan between volunteers. A series of network structure variables including degree centrality, betweenness centrality, density degree were calculated. A novel function-oriented network variable, termed activity performance was also introduced and calculated. The activity performance rank of the six lowest-betweenness-centrality-rank individuals were compared with their rank in gatekeeping list for validation of the new networ k variable.
    Findings
    The key members, gatekeepers and week members of the analysed social netwrok were identified. The network was revealed to be relatively homogenous. The average distance between individuals was 2.85 across the whole network and ranged from1.03 to 1.86 within the subnetworks. The individuals’ activity performance ranks were congruent with their betweenness centrality ranks, suggesting the validity of the introduced network varia les.
    Conclusions
    Social network analysis can help identify the strength and weaknesses of health-related networks in the primary health context. Elucidation of the network structural characteristics can help improve network interactions, reconciling the network paths, and reinforcing its structure, which in turn can lead to a higher performance of network-based health-related plans. The consistency between activity performance rank and betweenness centrality ranks indicate the validity of the former new variable as a complementary measure be used for a more informative social network analysis.
    Keywords: Social Network Analysis, Primary Health, Health System, Health Services Delivery, Health Services Performance
  • Seyed Saeed Tabatabaee, Vahid Kohpeima Jahromi, Mahbobeh Asadi, Rohollah Kalhor Pages 187-194
    Background And Objectives
    Medication error is the most important factor threatening patient safety. While the causes of medication error are extensively researched in the public hospitals, the corresponding data from the private heath settings is limited. To help fill this shortcoming, this paper presents and discusses the results of surveying the medication error factors as perceived by nurses in an Iranian private hospital.
    Methods
    This cross-sectional survey was carried out in a private general hospital situated in Mashhad, a Western Iranian city. The study sample included 97 nurses, randomly selected from the nurses working in different hospital departments. A literature-based researcher-made questionnaire consisting of 23 questions related to the causes of medication error incidents from the nurse’s perspective was used as the survey tool. The content validity of the survey tool was explored by using nursing experts’ opinions. The reliability of the tool was examined using test-retest method. Data were summarized using descriptive statistical methods. The factors contributing to the medication error were ranked based on their importance scores, and clustered into three major ranking categories: very important, moderately important, and slightly important. The relationship between the demographic variables and the perceived importance of the medication error factors was measured using Pearson’s correlation coefficient. T-test and ANOVA were used for comparison of the edical error factors between the demographic groups.
    Findings
    Low nurse-to-patient ratio, high workload and improper work assignment were found to be the most important factors contributing to medication error incidents. Nurses of Male Surgery Department placed significantly more emphasis on the role of low nurse-to-patient ration and heavy workload in medication error incidents compared to other nurses. Also nurses of ICU gave a relatively higher weight to the existence of very ill patients in department as medication error inducing factor, as compared with their other counterparts. A significant inverse relationship was identified between the nurses’ age and work experience, and their perceived importance of low nurse-to-patient ratio, nurse’s personal neglect, and nurse’s illegible writing in kardex; age also showed an inverse correlation with the perceived importance of heavy workload.
    Conclusions
    There is no fundamental difference in the medication error incident factors between the private and public hospitals. The perceived most important factors contributing to medication error incidents are those that influence the nurses’ quality of work life. Hence, a comprehensive strategy for major improvement of nurses’ quality of work life would concomitantly result in a reduced rate of medication error incidents. An effective medication error controlling strategy also should address the different nature ofneeds in different hospital department for successful results.
    Keywords: Medication Error, Patient Safety, Hospital, Nurse, Quality of Work Life, Healthcare Workers
  • Pejman Shadpour, Mehdi Barzegar, Elham Afzal * Pages 195-200
    Background And Objectives
    As with most countries, in the developing communities, providing high quality services in the field of health care is affected by limited financial resources. Applying the positive stimuli germane to the private sector to public hospital may be one solution to the public sector''s problems, and the health care system, in general, for reducing hospital construction and operation costs. One example can be designing proper cooperation contracts between public hospitals (non-governmental partner) as the holder, and a capital managerial proficiency, and large-scale facilities in that order. This study aimed at evaluating the benefits of implementing the public-private partnership model to Hasheminejad Kidney Center, an academic hospital, with the Moheb non-governmental organization in Tehran in 2013.
    Methods
    The survey population consisted of managers and staff of Hasheminejad Kidney Center in Tehran (total 50). Questionnaires were distributed to the study population, and the resulting data was subjected to descriptive analysis in all five known impact domains for public-private partnership.
    Findings
    The managers’ perceptions in all five public-private partnership domains were concluded as beneficial. Among these, quality of hospital services scored the most benefit (average = 79.8 %), financial enhancement stood at 78.4%, and benefits to the staff averaged 78.3%. Most importantly, the participants also found the impact of PPP on education and academic to be very positive (75.1%).
    Conclusions
    The results of our survey on this uniquely durable prototype of PPP between an academic hospital and an NGO confirm its decisively positive impact on all studied domains, including not only the expected quality of care and financial aspects, but convincingly for educational services as well.
    Keywords: Public Private Partnership (PPP), Management, Hospital, Education, Health care, Medical education
  • Maryam Ansary, Maryam Yaghoubi, Mehri Farzaneh, Alireza Shavakhi Pages 201-204
    Background And Objectives
    Philosophical mentality grant an individual the ability to think critically, analyse the situation correctly, make insightful decisions, and find appropriate solutions for the problems. Evidence shows that this mental capability can also positively affect the individuals’ creativity. In the health domain, where the complexity of healthcare procedures poses challenges to efficient management, presence of such a mental capability in healthcare managers is highly demanded. The aim of this study was to evaluate philosophical mentality in nursing managers of different demographic groups, and explore the correlation between their creativity and philosophical mentality.
    Methods
    Five hospitals were randomly selected from 11 teaching hospitals in the Isfahan city situated in central Iran. All nursing mangers in hospitals (80) were surveyed in the census. Smith’s philosophical mentality questionnaire was used as the survey instrument. comprising 30 items related to three dimensions of the construct, including comprehensiveness, flexibility, and contemplation. Data were summarized using descriptive statistical methods. Comparison of philosophical mentality between demographic groups was carried out using t-test and ANOVA. Relationship between the philosophical mentality and its dimensions and creativity was explored using Pearson correlation coefficient.
    Findings
    The mean philosophical mentality score was determined to be 72.5. The highest (80.10) and the lowest (63.50) score means were obtained for comprehensiveness and flexibility dimensions, respectively. No significant difference in score mean of philosophical mentality was identified between the two genders and between nursing managers of different levels of education. Creativity showed significant correlation with philosophical mentality and all its dimensions.
    Conclusions
    Philosophical mentality can be equally achieved by any nursing manager regardless of their gender and level of education. Our results encourage hospital administrators to develop training programs on philosophical mentality to enhance creativity and thereby overall managerial performance in their nursing managers.
    Keywords: Philosophical Mentality, Creativity, Nursing Managers, Hospital Management
  • Sheida Mardani, Seyed Jamaledin Tabibi *, Leila Riahi Pages 205-212
    Background And Objectives
    Mental and physical safety is one of the most important needs of human beings, and the administrators of each community should specifically care about it. Meanwhile, hospitals, which themselves are health care providers, are in no way an exception to this rule. Thus, hospital administrators are expected to take the issues related to physical and mental safety of staff and patients into consideration. The aim of this study is to determine the relationship between hospital safety and staff performance of Imam Khomeini Hospital, Tehran/Iran.
    Methods
    This is a correlational study. The statistical population included all employees of the hospitalization wards of Tehran Imam Khomeini Hospital (n = 200), who were selected by simple random sampling method (n = 65). Data collection was done using a questionnaire consisted of three sections; the first section for collecting demographic data, the second to measure the safety of the hospital (the independent variable), and the last one to measure the performance of employees (the dependent variable). Pearson''s correlation test was used to test the correlations.
    Findings
    The results indicated that there is a significant relationship between the safety of the hospital and each of the factors affecting the staff performance. «Quality» indicator shows the strongest correlation with safety followed by «cost», «accountability», «discipline» and «quantity». “Time” showed the weakest correlation with the safety performance indicators. In general, there was a significant correlation between the hospital safety and the employees’ performance.
    Conclusions
    Given the significant relationship between hospital safety and staff performance, the more the principles of safety are observed in a hospital, the better will become the staff performance.
  • Morteza Khavanin, Zadeh Pages 213-216
    Background And Objectives
    Medical error/malpractice is becoming a global healthcare problem bringing ever increasing number of physicians before the courts, and posing significant costs to the health system. Statistical analysis of the nature of complaints can help identifying the most vulnerable medical practices and thereby guide development of preventive strategies. This study surveyed complaints against physicians of different specialty involving in laparoscopic surgical operation, which has led to conviction of the accused physicians.
    Methods
    All files related to the complaints from physicians involving in laparoscopy investigated in Tehran Forensic Medicine Organization Committees during the years 2002-2008 were reviewed and the emographicsof the complaints, the complications occurred, and the specialty of the accused practitioner were recorded and summarized.
    Findings
    Of 1771 complaints filed, 59 (3.3%) were related to laparoscopic surgeries. The mean age of the complainants was 38.74 ± 7.21 years and 93.2% of them were female. While most complaints were from Gynecologists) 52.63 %(, the majority of complaints were related to in the private sector (72.9%). Major traumas were occurred during laparoscopic surgery (35.08%). Although the complaining patients were mostly under 50 years old, the majority of the lawsuits were filed after demise of the patients (36.1%).
    Conclusions
    Our study provides useful statistics that can be used in prevention of medical rrors/malpractices in the field of laparoscopic surgery. For hospitals to avoid unwanted complications and the consequent complaints, it is required to employ experienced surgeons in laparoscopic surgery. Special attention should be paid to female patients and accurate diagnosis of their diseases by Gynecologists. In addition, private hospitals should adapt quality of their surgery services to the high expectations of the patients requiring surgical operation.
    Keywords: Laparoscopy, Medical Malpractice, Complaint, Lawsuit, Surgery