مجله بیمارستان
سال دوازدهم شماره 2 (تابستان 1392)

In Iran، the rapid growth of urbanization is in a way that it fits into the appropriate location for urban spaces are not switching. The main consequence of this is failure of service delivery and service system to citizens. One of the most important public services that hospitals provide most of the citizens'' health. The purpose of this study، “Optimal locating of hospitals in region 7 in Tehran city”. This research is descriptive - analytical study has been done. For collecting information and data is used field studies and According to information obtained، To review the study area in terms of access to communication road، green space، away from industrial centers، military، and the fault، as well as for weighting the criteria، is used the AHP model. Then، using a decision model of TOPSIS in GIS software، valuation of criteria has been studied and appropriate maps is prepared، finally map that represents the best location for the construction of hospitals in this area is extracted. with combination and overlaying of data layers، the final map was obtained and determined that the northeastern section (Cross Resalat Street and cabli)، central (martyr Motahari streets and Miremad) and southeast (Bakhshi fard and part of Damavand street) in district 7 are have priority and more points to construct hospitals. System of Multi Criteria Decision Making (MCDM) with GIS can be used as effective tool in site selection of hospitals. Being located of hospitals، near to green spaces and comunication road and its distance from the industrial and military areas as well as the fault، capability of this model in this study is prove.

Patient`s self-discharge from the hospital is a process in which a patient leaves the hospital before completing his or her determined treatment period by his own will. This study is aimed to survey the factors affecting patient`s self-discharge from the hospital in emergency ward of a referred hospital. This is a case-control study. The 280 selected samples were divided to two groups، each with 140 members. The data were gathered using a questionnaire evaluating the scale of patients and their companions` satisfaction of the hospital services. Chi-square test was used for analyzing the relationship between independent variables and the patient discharge type. Moreover logistic regression was used in order to identify the effect of significant independent variables on own will-discharge possibility. Results indicate that there is a meaningful relationship between variables such as age، having supplementary insurance، residency، income rate، reference shift، reference day، satisfaction of the physicians، satisfaction of the physical environment and welfare facilities، the patient`s satisfaction، the waiting time، satisfaction of the instructions given by nurses and physicians and total satisfaction with discharge type (p<0. 05). The matter of patient`s self-discharge is a multi-dimensional phenomenon and depends on patient’s characteristics and structural and medical factors. Therefore predicting its scale and determining factors might play an effective role in controlling this phenomenon.

This research aims to design and implement a software with the ability to identify patients who are facing the risk of pulmonary embolism and deep venous thrombosis instantly as well as the ability to send timely reminders for any prophylactic action. The main target is introduce a clinical decision- support system which could finally lead to preventing mortality and handicap cases caused by embolism and thromboses in patients who are confined to bed in hospitals.

The software was designed using the Visual Basic. Net and SQL Server database. Afterwards the software was installed in the largest educational hospital of Kerman and a survey was conducted amongst the physicians using multiple questionnaires and interviews. Finally، the data were analyzed using the SPSS software.

The average score was 21. 16 for the physicians and 20. 76 for the nurses. T-Test results show that there is no significant difference between the total average score of the physicians and that of the nurses.

The results have shown that both groups (physicians and nurses) have a positive viewpoint about the software therefore using the clinical decision support system can be effective in reducing the occurrence of pulmonary embolism and deep venous thrombosis through sending timely electronic alerts to the medical staff.

One of the behaviors taken into consideration in organizations such as hospitals is organizational citizenship behavior. Recent studies have shown that organization employees show interest in organizational citizenship behavior and this subject may be influenced by demographic specifications. This study aims to determine the relationship between organizational citizenship behavior and demographic specification (gender، age، marital status، educational qualifications، salary&wage، ethnicity،employment type، work type، organizational post، place of employment and work experience) among selected hospitals employees of selected hospitals of Tehran and Shahid Beheshti Medical Sciencesis Universities. This research has been implemented in six selected Hospitals of Tehran and Shahid Beheshti Medical Sciencesis Universities and data was collected by distributing a questionnaire among 429 employees of these hospitals using a two-stages random sampling method. The research methodology has been cross-sectional- descriptive using field study. In order to accept or reject the research hypothesis kruskal-wallis and mann-whitneyU tests have been used. Results showed that، the most studied demographic characteristics have an effect on organizational citizenship behavior of the staff of selected hospitals employees in Tehran and Shahid Beheshti Universities of Medical Sciences. Findings of this research indicated that men have shown more organizational citizenship behavior compared to women، Married people have shown higher organizational citizenship behavior compared to single and divorced people and people in the age class of 50 to 54 years have been the highest organizational citizenship behavior average. In addition to، people with master degree، have been the highest organizational citizenship behavior. Also our findings show that Ethnicity does not have effect on the incidence of organizational citizenship behavior.

Today using contrast media in order to diagnose different tissues in radiology section has found a vast range of applications. Thus application of safe procedures and protocols in usage of contrast media to prevent dangerous reactions seems to be of great necessity. That is why in this study we aimed to evaluate the safety of intravenous administration of contrast media in the radiology sections of medical-educational Centers of Urmia.

This is a descriptive and cross sectional study. Data were gathered using questionnaires derived from articles and international standard guidelines such as (ESURE، RCR) in three areas including: drugs، protocols and facilities.

Results indicated that the level of compliance with safety protocols، facilities and drugs were 91. 3% and 69. 4% and 100% respectively. The average safety observance was 80. 9% totally. The results showed that there were some deficiencies in some equipment such as pulse Oximeter and ECG. Moreover، it was found that a unique protocol is not used in all surveyed sections.

Regarding the importance of this issue it is necessary to publish and implement a unique protocol for contrast media administrating and to provide all required equipment for improving patient safety process. Meanwhile a wide supervision should have been done by related authorities in or out of the organization.