فصلنامه مدیریت پرستاری
سال سوم شماره 3 (پیاپی 11، پاییز 1393)

Patient education is the missing link for effective clinical care in our hospitals. In accordance with the mission of the health system, lack of a coordinated policy in organized human resources in patient education services, resulting in a failure to provide effective services to patients to achieve "self-care". To introduce a semi-centralized organizational model emphasizing the pivotal role of nurses in organizing patient education services. This study is part of the reflection phase of the Nurse-Educator's Al-Zahra Role Expansion Action Research(NEAREAR Project) in Al-Zahra educational Hospital in Esfahan which has been started from January 2012, conducted through Enhancement-Emancipator Model of action research. By organizing three groups of the Core Team, Steering groups and Feedback communities and using leadership for change skills, the strategic process and operational planning of the participatory project led to development of patient education services. Data on organizational structure, interactions and roles of nurses in organizing above mentioned actions, purposefully collected from 115 administrative correspondences, over than 1,000 emails and 740 pages of documentation during clinical-academic partnership. Conventional and summative qualitative content analysis was performed on a continuous basis. From the enlightening process of the Living theory of action research, themed "the nurse's role as leaders and managers", the "Nearer organizational model", was extracted for organizing patient education services in Al-Zahra educational Hospital with approval of 10 experts; including structural themes, participatory programs and closer academic-clinical interactions in both health care and therapeutic sectors. The "Nearer model" represents organized efforts of nurses in the establishment of an semi centralized professional structure of a scholar action research project, led to encourage nearer participation of the three executive components of healthcare system in the Deputies of Education & Research, Health and Treatment in the triple context of the underlying elements of the community resources, recipients and providers of health care services, that resulted to the development of the patient education services in a hospital. The model explains how the collaborative actions of educational research, health care, can be closer by effective role of nurses in organizing and expanding patient education services during a participatory action research project. Given the positive results of the study, and according to the formation of Nursing Deputy in our Health System in Iran, it is suggested to test the model for promote the role of nurses in patient education services through action research for development of the patient education services in similar fields or in larger scales.

Job strain is an inevitable part of the nursing profession that has important consequences such as dissatisfaction and decreased of quality of care. Nurse's psychological empowerment would be vital role in reducing psychological strain in the work place, through increasing staff efficiency, motivation and creativity behaviors.

The aim of this study was relationship between psychological empowerment and psychological strain among clinical nurses in educational hospitals in Shahrekord city.

This study's design was a descriptive-analytical that was done on (200) clinical nurses who worked in Hajar and Kashani hospitals in 2013. They were selected by quota method. Data were collected by psychological empowerment (Spreitzer, 1995) and psychological strain (Osipow, 2001) questionnaires. Their reliabilities were (0.90) by α- Chronbach. The data were analyzed by the software Spss16 and statistics tests; such as t-test, ANOVA and Pearson correlation.

Results showed that only "work meaningfulness" in dimensions of psychological empowerment questionnaire had relationship with psychological strain (P< 0/05).The mean of psychological empowerment and psychological strain among nurses was moderate to high.

Based on findings would be comment that improving self-worthiness in nurses and also considering ways for increasing this nurse's feeling would be decreased nurse's psychological strain and their effectiveness in health system have a vital role.

Increasing growth professionalization in nursing resulted to importance the concepts of nursing knowledge and enrichment of structure of nursing knowledge. Nursing as a scientific profession for providing nursing services to clients should be notice and deep understand to creation, disseminate and applying knowledge. The main aim of this study was explored clinical nurse's perception to atmosphere of creation knowledge. This study was done in qualitative approach and content analysis. Semi- structures interviews (17) with clinical nurses and head nurses who selected purposefully were done. They were worked in teaching hospitals; Imam Khomieni and Shariate in Tehran city in 2013.Data were analyzed with Conventional Content Analysis. Findings showed that four themes derived from content analysis; scientific discussion, sharing clinical experiences, enrichment clinical rounds and conferences and inter- relationship. Based on results, atmosphere of creation knowledge is an interactional atmosphere, so, nurse managers should be provide situations that clinical nurses have inter relationship with colleagues, share their selve's experiences and have clinical rounds more than now.

Medical errors are one of the major threats for the patient safety in all countries. Medication errors are the most common medical mistakes. The aim of this study was to develop a theoretical model of human error mixed method with the cultural context of the health care system is in Iran. This mix method study was done (quantitative – qualitative approach) in Shahid Beheshti University of Medical Sciences Hospitals in Tehran in 2013. The quantitative section, factors associated with medication errors in the Reason human error model were tested. The nursing staffs (n = 150) were selected and completed these tools; demographic data, Velasquez (2005), Salyer (1996), Gittel et al(2000), Minick et al(2003), Wakefield et al(2005) and Rybowiak et al(1999) and organizational factors based on Reasons Human Error Model. In the qualitative section, data were collected by semi-structured interviews with 20 nurses who were selected using purposeful sampling. Using SPSS-PC (v.16), and LISREL 8.8 data were analyzed by descriptive and path analysis tests (P_ value<0.01). showed that the age of the majority of nurses ranged between 31 to 40 years old (44.7%) and they had 10.60±7.24 years of work experience. Model fit indices showed that the paths considered for relationship between variables was appropriately predicted. Learning climate correlated with work commitment with standardized coefficient of (r =0.40) and learning climate correlated with physician - nurse communication with standardized coefficient of (r =0.20). There was no significant relationship between other variables (such as; work environment factors: complexity of care, work dynamics, and individual factors; such as age and work experience). In the qualitative section content analysis derived three themes, individual factors: "individual characteristics and psychiatric nurses, "error caused by doctor's orders", Organizational factors: " working conditions "," nurses medical information "," unavoidable error in nursing ", characteristics of patients “and" complications of medical error" and also, Organizational culture includes "learning process" and "risk management process". For designing model Mixed these two section results could be mixed and the findings showed that factors organizational might be considerably in error occurrences. Nurse managers to understand organizational factors and organizational culture important to prevent these errors, take actions to eliminate these factors and reduce the incidence of medication errors in the priority of their program.

In nursing care; work sensitivity, job anxiety and delivery high quality nursing care to the patients resulted to necessitate nurse's organizational citizenship behaviors. So, reorganization these factors that influence on nurse's organizational citizenship behaviors are important. Because these factors could be helped to nurse managers who consider them for high qualified nursing care planning. The aim of this study was identify the relationship between organizational identity, nurse's job satisfaction and extra-role behaviors. This is a descriptive-correlational study that was done by in (2012).All of the nurses in the Imam Khomeini hospitals in Urmia city were samples that cluster sampling was used with proportional allocation for each unit. By using Morgan method (201) nurses were selected randomly. For data gathering these questionnaires were used; Corporate Identity (Ashfourt& Miley, 1989), job satisfaction (Brayfield&Roth, 1951) and Organizational Citizenship Behavior (Podsakouf& et.,al 2000) that their reliability by α –Chronbach were (0.75, 0.73 and 0.77) respectively. Data were analyzed by linear correlation and path analyses by SPSS (19) software. Organizational identity and nurse' job satisfaction (0.48), and nurse's job satisfaction with organizational citizenship behaviors (0.57) had direct and positive relationship (p<0.01); that it was more effect than the other variables. And organization identity with nurse's extra-role behaviors (0.28) had indirect and positive relationship (p<0.01). Organizational identity and job satisfaction together predict variance (0.29) nurse's organizational citizenship behaviors and also, organizational identity predicts variance (0.20) nurse's job satisfaction. In order to finding, suggests to nurse managers and hospital administrators for increasing nurse's perception to organizational identity planning that it would be promoted their job satisfaction; and it is provide suitable context for nurse's organizational citizenship behaviors.

To meet the growing and emerging new health needs, it is essential that nurses develop scope of their practices from hospital to community and be prepared for entrepreneurship roles in care different levels. Strong incentives are required to choose entrepreneurial career paths, risk-taking, tolerance for ambiguity and deal with a variety of obstacles.

The purpose of this study was to explore and describe the perception of Iranian nurse entrepreneurs from entrepreneurship motivators.

A qualitative design using a content analysis approach Graneheim and Lundman's (2004) was applied for data gathering and analysis in 2013-2014. In this study thirteen nurse entrepreneurs were selected through purposive sampling. Unstructured interviews were conducted to collect data.

The data analysis resulted in five main themes: professional promotion, social advantages, spiritual achievement, financial achievement and employment.

The findings shows that nurses to engage in nursing entrepreneurship need higher motivations such as professional promotion, social advantages and spiritual achievement. The findings can be used for tendency to nursing entrepreneurship in nurses and nursing students.

Educational supervision is the most important ways that resulted to efficiency and quality improvement in higher education system. For implementing ideal supervision, educational managers should be assess and diagnosis facts of it and then planning for it's effective management. The aim of this study was diagnosis of educational supervision facts in a universities that might be effect on supervision performance educational managers, positively or negatively. This study was content analysis as a qualitative study. Educator and educational department's managers participated in this study who were worked in nursing school in Medical Sciences University of Mashad. They were selected purposively. Data were gathered by (10) semi- structured interviews that they recorded and then transcribed carefully and analyze by Conventional Content Analysis. Six explicit themes derived from interview's content analyses; time shortage, variety of roles, staff shortage, complex supervision's identity, difficulty of expert's supervision and lack of authority fit to supervision. For quality improvement in nursing education should be use different method for educational supervision in universities; such as participative supervision for problem solving.