افشین محمد علیزاده

Respecting patient rights is the most important of ethical issues in a hospital. The aim of this study was demonstrating the role of implementing clinical guidelines in respecting patient and hospital rights.
This study was carried out as an applied, descriptive and cross-sectional study in 2015 for (N=438) ICU admitted patients in selected hospital. In order to measuring patient rights indicators, standardized questionnaire was used and Hospital Information System used for Hospital rights indicators. Descriptive tests (percent, frequency) and inferential tests (in depended T-test, Mann Whitney) were used for data analysis by SPSS 20.
Ethical Considerations: All of data were used by owners’ permissions and without the patient names and characteristics.
Findings: In ICU, The average length of stay before and after implementing guidelines was 4.4-3.56 days (P-Value=0.042). Turnover of bed rate calculated before and after implementing 6.8-7.9 (P-Value=0.027) average interval bed turnover was leveled off at zero (P-Value=0). The total patient satisfaction rate was 75% and 95% (P-Value=0.032). Satisfaction from medical services was 53.3% and 86% (P-Value=0.026), satisfaction from nursing services was 53.3% and 71% (P-Value=0.038) and discharge against medical advice was 1.4% and 1.06% (P-Value=0.042) before and after implementing clinical guideline respectively.
The findings showed that implementing clinical guideline has a positive role in respecting patient and hospital rights. Therefore, strongly recommend to policy makers and hospital managers, by implementing admission guideline not only efficiency and effectiveness of limited resources will be increased but also hospital has a great consideration to ethical issues in healthcare services.

One of the most important causes of mortality, costs and length of stay in hospitals is nosocomial infections. The aim of this study was to analyze the situation of nosocomial infection in Tehran Taleghani Hospital.
This study was a cross-sectional, descriptive and survey. Researcher collected the data from culture positive patients, chart temperature, according to a survey of the different parts of the hospital (infection control expert walk round) for one year in 2015, then entered in INIS software and reporting the frequencies.
The highest prevalence of nosocomial infections was reported among adults (15-65) with 83.17 % of bloodstream infections (48%), respectively. In terms of microorganism, the highest of Kelebciella (20%) from ICU was detected.
Regardless of people age as well as involved systems, type of microorganism and also highest prevalence ward were consistent with previous studies.The results showed that entering timely, accurate information and continuous reporting in addition to the immediate notification to managers could be crucial in decision making for effective corrective and preventive action.

There are many hidden threats in government-run hospitals that affect the incidence of medical errors. The aim of the present study was to determine the frequency and types of medical errors in Taleghani Hospital affiliated to Shahid Beheshti University of Medical Sciences in 2014.
In this descriptive-analytical study, the voluntary error-reporting form was used for data collection in accordance with the standards of the patient-safety-friendly hospitals. Of the 300 forms distributed, 162 error reporting forms were collected during one year, and the data for each form was entered into the software by determining their Identification code. SPSS version 19 software was used for the quantitative tests, and the comments by 10 experts were drawn upon for causal analysis of the data.
Ethical Considerations: Completion of medical errors form report was carried out voluntarily, anonymously, without naming the error reporter, and the unit where the error had occurred.
Findings: The total number of errors reported was 158 errors in 2014. Frequency of the errors consisted of medication errors 38.6%, errors in treatment 36.1%, and errors in recording 25.3%, respectively. Events statistics was 33.5% for incident events, 15.2% for accident events, and 1.3% for sentinel events. Medication errors analysis based on the six principles of drug administration included wrong patient (32.14%), wrong drug (18.7%), wrong order (15.3%), wrong prescription (14.96%), wrong dosage (11.9%), and wrong time (7%).
Despite informing the people and holding educational sessions, there still remain some barriers to reporting errors in the health system. Hence, professional ethics education and error systematic management approaches are recommended.

Judicious use of antibiotics is essential considering the growth of antimi-crobial resistance and escalating costs in health care. Ceftriaxone is a third-generation cephalosporin used widely for the treatment of various infections in outpatient and in-patient. The purpose of this study was to evaluate the ceftriaxone utilization before and after implementation of guidelines and physicians education. A descriptive cross-sectional، before-after intervention study was performed in 6 wards of a teaching hospital in Tehran، Iran. The study was conducted in three phases: pre-guideline، educational interventions and post guideline implementation. The pre intervention phase included chart analysis of current ceftriaxone use in 200 consecutive patients from the representative wards included in the study. The educational interventions included preparation and distribution of ceftriaxone guidelines as pamphlets among physicians working in the studied wards. Also the clinical pharmacist returned to each ward and trained physicians regarding the correct use of ceftriaxone. In the post intervention phase immediately after the instruction، and in the follow up phase، one month later، a prospective analysis of ceftriaxone utilization was performed by chart review of 200 patients to detect changes in ceftriaxone utilization pattern. Four hundred cases were evaluated during study (200 before and 200 after physician’s education). The correct indication of ceftriaxone was 93% and 96% before and after the educational interventions respectively. Analysis showed that correct indi-cation of ceftriaxone did not change significantly before and after education (P= 0. 188). Regarding to proper administration (dose، interval and duration) ceftriaxone utilization significantly changed after education (P< 0. 001). Adoption of the guidelines with associated training resulted in significant improvement in ceftriaxone administration pattern in the hospitals.

With respect to the high expenses of obesity treatment and its associated complications, there is an urgent need for a suitable approach towards behavioral change in obese subjects. The present study was conducted to determine the association between body mass index (BMI) and sociodemographic factors among Iranian females aged 15-44 years.

For this cross sectional study, 2969 females aged 15-44 years were selected through a cluster sampling. We evaluated BMI and its association with occupation, educational level, family size, place of residence, marital status, and age. Logistic regression analysis was used to eliminate the effect of confounding factors.

The mean BMI was 25.6±5.2kg/m2, while 46.2% of subjects had normal BMI, however, 4.6% had severe obesity. BMI was significantly higher among 35-44 years old, married, illiterate, and house keeper females. Regression analysis showed that illiteracy and lower educational level could increase BMI.

Our results revealed that the mean BMI of Iranian females exceeds normal value, however, during a 5-year period the frequency of obesity did not alter significantly among females aged >20 years. Age increment, illiteracy, marriage, and housekeeping are associated with higher BMI level.