Modern Care Journal
Volume:3 Issue: 3, 2007

Hospital is an institute whose main strategy is providing diagnostic and treatment services for different medical situations, surgical or non- surgical. Staff is the most essential work force constituting health and treatment organizations and nurses, the largest professional group in a health care system, provide the largest part of direct care for patients, so they playa very important role in maintaining and improving the health of the society. Critical goals of hospitals will not be achieved unless the required numbers of qualified nurses are provided in proper time and place. The present study was conducted to survey the size and combination of nursing staff in affiliated treatment centers to Birjand Medical University and comparing with the complied standards of the ministry. We hope that the present study be able to take a step towards planning and reaching those standards and eventually improving quality of care. In this descriptive- comparative study the size and combination of nursing staff in affiliated treatment centers to Birjand Medical University in 2006 were investigated. Data was collected by the cheek list staffmg estimation table based on the systemic approach of the ministry. Then, the present personnel situation was compared with that of the standard one. The results shortage rate (or ratio) of nursing staff to available active beds, which themselves are less than the standard number per population, is in Imam Reza (AS) hospital 49.67%, in Vali-Asr (AS) hospital 29.6% and in Qaen hospital 47.3%. In Nehbandan, Sarbisheh and Sarayan, there are treatment centers, which are working as day- and- night (24 hours) clinics and have a number of beds in the emergency room and in the clinic. Regarding to the active beds nursing shortage in Nehbandan, Sarbisheh and Sarayan, was 55.8%, 57% and 70.6% respectively. Also, the results show that the maximum shortage of staff is in professional nurses. Since the most important factor in improving quality of care is providing sufficient number of staff, so standardizing size and combination of nursing staff can take an effective step towards the satisfaction of patients, clients and nursing personnel.

Children's optimal growth and maturity necessitates good nutrition and mother has an important role in children's health lack of their awareness leads to different disorders. This research has been done to determine the effect of education on mother's knowledge and practice about supplementary nutrition for children less than one year. In this quasi-experimental research 30 mothers £rom different health centers in Birjand, whose children's growth curve was 2 standard deviations below standard according to age and gender, were interviewed. The questionnaire contained 80 questions for knowledge and practice evaluation and then scores was scaled in 3 levels: weak, moderate, good. At first basic information were collected then mothers educated through group discussion, showing films, slides, and pamphlets. After 15 days questionnaires were completed again. Data were analyzed by SPSS software through descriptive and inferential statistics. The average age of children was 2.16±0.69 month and the average age of mothers was 32±0.57 years. 66% of mothers were unaware about the age of starting complimentary food, 26% about the age of starting iron drop and 40% about starting age of multivitamin drop, 13.33% about the kind of complimentary food. Most of mothers didnt have right information about starting age and how to nutriate their children with different nutrients. There is a statistical significant difference (p= 0.004) between mean scores of knowledge before (0.37±1.07) and after education (0.62±1.49). Also mean scores of practice before (0.54±1.31) with after education (0.73±1.96) different significantly (P=0.00). The mean age of starting supplementary diet in children didnt related to mother's job, educational level and age, but the mean age of quiting breast feeding and mean age of starting multivitamin drop had a relationship with birth rank of children (P=0.05 and P=0.002 respectively). Since starting the supplementary nutrition before 4 months ages can cause infection, malnutrition and allergy so proper educational programs for mothers is important and possible problems about breast feeding until 6 months should be investigated.

A meta-analysis is a systematic quantitative review of original research studies about some phenomenon, such as the effect of a specific treatment on some aspect of health or behavior. The meta-analyst expresses the magnitudes of effects from all relevant studies in the same units, then uses an appropriate weighting factor (the inverse of each effect's error variance) to combine the magnitudes into a mean value and its uncertainty (confidence limits). In a traditional meta-analysis, the true effects are assumed to be homogeneous (have the same value) in the analyzed studies, and some "outlier" studies may be eliminated to satisfy this assumption. In the more recent and realistic random-effect or mixed-model meta-analysis, true values of all effects are assumed to be heterogeneous (different), and the analysis provides an estimate of the heterogeneity as a standard deviation representing unexplained typical true variation in the effect between studies. Inclusion of study and mean subject characteristics in the analysis as covariates may reduce heterogeneity and provide further useful information about the magnitude of the effect in different locationsand with different subjects. Published effects are usually larger than their true values, owing to the misuse of statistical significance as a criterion for publication. A funnel plot can detect such publication bias, but there is currently no satisfactory way to adjust for it in the meta-analysis, and the only long-term solution is to ban statistical significance.

Patient's information is collected in assessment, fIrst step of nursing process and it helps nurses to determine nursing diagnosis and interventions implement them and evaluate their result. So Nurses need to learn skills and techniques of physical examination and they should be put in nurse's curricula and continue in their work period. This study was conducted to evaluate self-evaluation and nurse's educational needs about patient's physical examination in hospitals affiliated to Birjand University of Medical science. In this descriptive- analytic study nurses with BS degree who are working in hospitals affiliated to Birjand university of Medical science were selected through simple random. Data was collected by a questionnaire including two parts; fIrst: 9 questions related to demographic characteristics, second: 38 questions about main goals of study. The fIndings were organized in two parts; First: related to self evaluation in 5 steps (very good, good, average, bad, very bad) and second: related to determine level of educational need in 3 steps (advance, average, basic). Data was analyzed through t test and Pearson corolational coefficient by SPSS. From 104 Nurses were participated (88.5%) were female, with mean age 30.44±6.2 and had work experience 7.27±6.35 years. Most of them worked in ICU (15.4%), general medicine (13.5%), CCU and emergency department (10.6%). The highest and scores of self evaluation was related to preparation in preducers clinical blood, urin tests and electrocardiograph (EKG) and the lowest scores of self evaluation was related to procedure and indication of Trans ilominator. The majority of Nurse's educational needs in advance level (55.8%) was related to clinical blood, urin, stool tests and in average level (51.9%) was preparation for chest x ray and abdominal- pelvic sonography and in basic level (30.8%) was preparation and indication (MRI). Female nurses evaluate themselves better than males and there was no signifIcant statistical relation between self- evaluation with age and work experience. Since one of main methods for stable care is systematic, results showed determining nurse's educational needs, workshops and continuous education for improve quality of care is important.

Hospital solid wastes compose important amounts of municipal solid wastes. These materials contain pathogenic and hazardous agents that threaten the health of patients, staff and many other persons. This study was done to determine the quality of collection, transfer and disposal of hospital solid wastes in Birjand. A descriptive study carried out in all hospitals of Khorasan-e-Jonoobi province during the year 2008; the study included 2 governmental and 1 Tamin-e-ejtemaii hospitals. Data were gathered via a questionnaire and a revised observational form (check list) in six parts, which their validity and reliability have already been confIrmed. Each datum was allocated a number. In terms of the marks and ranking by a Likert scale (excellent, desirable, relatively desirable, weak), data were statistically analyzed in P≤0.05. Vali-e-Asr hospital had 200 beds or 54.7% (the most) and 54% of work force but Imam Reza hospital had 53.7% of operating rooms. The total sum up of the scores gained through the revision forms showed that regarding collection, transfer, storage and disposal of the wastes, Vali-e- Asr was the excellent one and the 2 other ones i.e. Imam Reza and Tamin-e- ejtemaii were desirable. In terms of radio active wastes, Imam Reza and Vali-e-Asr hospitals were similarly excellent but Tamin-e-ejtemaii hospital stood in a desirable position. Collection, transfer and disposal of hospital solid wastes in Birjand was desirable. It is recommended to segregate the wastes at source and to burn the hazardous parts, then bury them with other wastes. It is necessary to consider an appropriate technology and management and a statutory supervision on a safe waste handling process, especially in heath centers other than hospitals.

According to the importance of nutrition teaching to vulnerable groups by nurses and the controversies in its quality and quantity, and also to determine the impact of teaching nutrition workshops on nurse staff knowledge and attitude, this research was conducted in hospitals affiliated to Birjand University of Medical Sciences in 2005. This was a semi (quasi)-experimental study conducted on nursing staff who were working in the hospitals affiliated to Birjand University of medical sciences. They were selected by census. Data were gathered by 3 part questionnaires, which the first part included 10 questions on demographic features, the second part contained 20 questions measuring attitude and the third part 20 questions of knowledge. The data were analyzed by SPSS, parametric statistics (t-test, intraclass variance analysis and correlation co-efficient) and nonparametric tests (Chi-Square) in P≤0.05. 120 nurses working in the hospitals affiliated to Birjand University of Medical Sciences participated in this study. Most of them were female (92.5%) ranging ITom 31 to 40 years (40%) and Bachelor of nursing (56.7%). The means of knowledge and attitude scores regarding milk and its products consumption, variety and balance in diet, diet in hypertensives, diabetics and overweight patients, before immediately and three weeks after teaching were compared; the difference was statistically significant (P>0.001).With stepwise linear regression, among many factors affecting the increase of the mean of knowledge score after teaching, two factors were found to be related: educational level (P=0.000) and being educational or non-educational hospital.(p=0.002). Also the hospital which the nurse was working related to the increase of attitude scores (P= 0.006). Since nurses may play an important role in nutrition assessment of patients, nutritional care, counseling and providing nutritional advice to the patients and their families, increasing their nutritional information provides more opportunities to fulfill the mentioned responsibilities more desirable.

Evidence- based practice (EBP) is introduced as the bridge between research and practice. A common defmition of evidence-based practice is the application of current best evidence in making decisions about patient care. Developing an EBP intervention consists of five major steps: ask a clinical question about what the best approach to client care is, search and appraise the existing evidence, combine the research evidence with (a) clinical expertise and experience and (b) patient preferences and values, plan and carry out the intervention, and evaluate the outcomes. These steps are discussed in the present study. Unfortunately studies demonstrate that the most nurses do not realize the last available research in promoting nursing cares. Lack of time, the communication gap between researcher and clinician, organizational culture, lack of availability of pertinent research, limited access to journals, little experience and low comfort levels with search techniques, limited ability to understand and interpret research reports, limited exposure to research-use strategies during education, negative staff attitudes toward research, lack of administrative support as well as cost constraints have been identified as barriers to the implementation of evidenced-based practice by registered nurses. Recommendations for overcoming these barriers are presented in the current article.

Medicine with herbs is one of oldest methods for treatment. It backs to 60000 years ago. Unfortunately, people and even sometimes experts familiar with herbs think that medical herbs, because of being natural, dont have any side effects. Increasing usage of herbal products caused to do an investigation with the aim of "evaluation patient's knowledge and attitude hospitalized in Vali-e-ASR and Emam Reza hospital toward common regional herbal medicines". This investigation is a descriptive -analytical study which has been conducted on 275 patients with more than 20 years old, Hospitalized in Valie Asr and Emam Reza Hospital. Sample was selected by convenient method and 95% confidence interval. Data was collected through a questionnaire including 3 parts: demographic information (7 items); knowledge evaluation (9 items); and attitude evaluation (10 items). Data was analyzed by SPSS and statistical tests t, X2 and analysis variance tests. Mean knowledge score in female and male was 2.36±8.65 and 2.77±7.96 respectively, and mean attitude score in female and male was 8.76±30.98 and 8.4±30.5. The knowledge score was higher in female and in people with academic education (P=0.01, P=0.02). Attitude score was higher in female and in married people (P=0.05, P=0.01) According to good attitude and high rates of using the herbal medicine, it is necessary to do systematic researches to examine their efficiency and effectiveness in the society, planning to standardize them and determining the position of this type of medicine in treatment of patients and academic education.