فهرست مطالب mahboubeh asadi

Prevalence of risk factors for health is growing rapidly in developing countries due to urbanization. In fact much of the global burden of some conditions such as ischemic heart disease is currently in low- and middle-income countries. Therefore, an integrated and effective clinical guide is highly needed for management of patients with stable angina.

Databases and web-related documents were searched in order to extract clinical guidelines on stable angina. After assessing the quality of guidelines, three were selected based on the Appraisal of Guidelines for Research and Evaluation (AGREE) Instrument. Then, a national guideline was compiled along with evidence and recommendations by the panel of experts.

Findings were presented in the form of clinical recommendations. For example, acupuncture should not be used in improving or reducing the symptoms of cardiovascular disorders in patients with stable ischemic heart disease.

Considering 92 recommendations in this guideline and its adaptation in the Iranian population, this clinical guidline and its recommendations can be effective in standardizing services, screening, referral, diagnosis, treatment, and follow-up of patients with stable angina.

Background and purpose: Lack of clear boundaries and standard reference about the diagnosis of stroke, necessary evaluations and interventions, effective treatments, and referral of stroke patients resulted in various inconsistent services. Therefore, this study aimed at developing practical national strategies for stroke in Iran. Clinical guidelines about diagnosis and management of stroke were extracted from different guidelines. Three guidelines were selected according to AGREE scoring system after quality assessment and evaluation of clinical guidelines. In order to adapt the guidelines, recommendations of the three clinical guidelines were recorded in the form of clinical questions. Evidence supporting each recommendation was identified based on references and compared in terms of initial outcomes. Cost of interventions, the side effects, and clinical benefits were also studied. Finally, the national guideline for management of stroke was developed. The results of this investigation were presented as clinical recommendations for diagnosis and management of stroke (2016). For example, strict control of blood glucose level and fever in patients with aneurysmal subarachnoid hemorrhage was recommended in the guideline. The current indigenous stroke guide for the Iranian population is believed to be of great benefit in screening, referral, diagnosis, treatment, and follow-up of stroke.

Children are important component of future society and providing their health care is a national investment. With regard to close contact between mother and child, so, improving the mothers’ knowledge about neonatal care and the risk factors can be effective to prevent neonatal mortality and morbidity. This study was performed with aim to evaluate mothers’ knowledge about neonatal care in three educational hospitals of Mashhad University of Medical Sciences.
This cross-sectional study was conducted in 2014 on 784 pregnant women referred to maternity wards of Omolbanin, Emam reza and Ghaem hospitals. The data collection tool was a researcher-made questionnaire on neonatal care. Data were analyzed by SPSS software (version 16) and using t-tests, Chi-square and ANOVA. P The knowledge of 50 mothers (6.4%) about neonatal care was poor, 430 (54.8%) moderate and 295(37.6%) good. The mothers with diploma level education had the highest level of knowledge than other mothers. There was significant relationship between mother's level of education, job and mode of delivery with mother's knowledge about neonatal care (P=0.005).
Due to the effect of mother's knowledge in the prevention of neonatal disease and mortality, it is better to focus more on educating mothers, especially in the field of mother’s diet and exercise, nipple cracking, and safe drugs during breastfeeding for all mothers.

Information and knowledge are one of the most valuable assets of an organization and as a source for the survival of organizations is vitally necessary. Today, for having a continuous presence and stability in the commercial and competitive world, an organization should work on Knowledge-based approach. In order to use this valuable source correctly, knowledge management is on the agenda of the leading organizations. Accordingly, the present study was conducted as a descriptive-analytical and cross-sectional one to assess the impact of knowledge management on the level of confidence toward the information technology among staff working at Mashhad University of Medical Sciences. The sample size was estimated about 377 by Morgan table and selected by simple randomization method. Data were collected by a researcher-made questionnaire which its reliability and validity were confirmed; and then Data analysis was performed by SPSS version 16th. Total score of trust in IT and knowledge management among employees were estimated 3.14 ± 0.76 and 3.39 ± 0.61, respectively. According to the results, there was a direct correlation between knowledge management and staff confidence in information technology (p-value ≤ 0.001, r = 0.436). Moreover, the positive correlation among the examined factors were assigned to components of recording and maintenance knowledge (p-value ≤ 0.001, r=0.472).Therefore, it appears essential for health managers to be successful in their organizational mission to focus on using the Information Technology as well as upgrading and updating of staffs’ knowledge of IT.

According to the importance of managers’ role in improving quality of health services, we performed this study to survey hospital managers attitude about patient complaints investigating system in hospitals affiliated to Mashhad university of Medical sciences in 2015. This descriptive cross-sectional study was performed in 12 hospitals affiliated to Mashhad University of Medical Sciences. One questionnaire that we had confirmed the reliability and validity of that was used to assess hospitals managers’ attitude about patient complaints investigating system. Study population was all hospital managers in all levels. We studied them as census. Finally 130 completed questionnaires were analyzed with SPSS Version 16. 20% of managers assessed the current status of patient complaints investigating system as improper. 35% of manager expressed not using information that derived from patients’ complaint as most defect in patient complaints investigating system. 60% of managers believed that the most impact of reinforcement patient complaints investigating system is improvement of services quality and system validity. Finally 56% of managers expressed staff dissatisfaction is the great reason for patient complaints. According to the findings and relatively positive attitude of managers, it is necessary to organize a team for improving and revising patient complaints investigating system in each hospital. Also managers’ attention to staff satisfaction and their educational needs is important for reducing patient complaints.

Evidence-Based Medicine (EBM) means ensuring that the right patient has received the appropriate treatment and it strives to form a common scientific language for all doctors. It uses the combination of the best available knowledge (evidence) and clinical experience beside the patient values. This study was designed to investigate the attitude of medical residents of Mashhad University of Medical Sciences towards EBM. In this cross sectional study a self-designed questionnaire was used for data collection. The study was performed in the autumn of 2012 in Mashhad University of Medical Sciences, Mashhad, Iran. The study aimed at investigating the attitude of medical residents towards EBM and evaluating its use in medical practice. Questionnaires’ data were analyzed by the SPSS Version 13. 49 (52.1%) residents were familiar with the concept of EBM whereas 45 (47.9%) were not. The rate of familiarity with EBM concepts was (26.5%) in the surgical fields and (73.5%) in the non-surgical ones, showing a meaningful difference (p=0.014). There was a significant correlation between the field of study and knowledge about the concepts of EBM, whereas a greater number of non surgical residents were familiar with its concept in comparison to surgical residents (73.5% vs. 26.5%, p=0.014). The concepts of EBM are familiar to (82%) of medical residents of Mashhad and regarding the increasing importance of this science, upgrading EBM concepts in a timely and accurate planning is highly recommended.

one of new and unique tools for survival of organizations among their competitors having comprehensive knowledge of all the environmental factors affecting the organization, means organizational intelligence, that with its measurement Strengths and weaknesses of the organization are identified and can affect the performance of organization and in this way, they help to organization in the measurement and evaluating progress in achieving its goals. This descriptive analytical study was performed in 12 general hospitals affiliated to Mashhad University of Medical Sciences in 2012. Study samples were 375 employees who were selected through stratified sampling method. The study Tool of data accumulation was Albrecht organizational intelligence standard questionnaire and checklist of hospital performance indicators that was determined by the Ministry of Health. To determine score organizational intelligence was used the five-point Likert scale. Data were analyzed by SPSS v.16 using Statistical tests and Pearson correlation coefficient (P=0/05). we found that there was a significant positive relationship between hospitals’ organizational intelligence and all the performance indicators of the exception of “Bed occupancy ratio”, “Ratio of surgeries to operation beds” (P<0.05), and organizational intelligence had the highest correlation with indicators of Bed Turnover Interval (r = 0.739) and the average length of patient stay (0.691). it seems that attention and planning to strengthen and increase organizational intelligence can be effective in improving the performance of hospitals.

Clinical Governance (CG) is a systematic approach to the maintaining and improving the quality of provided services for patients in the health system. With regards to the implementation of clinical governance in hospitals affiliated to Mashhad University of Medical Sciences and the role of matrons in ensuring quality care, little is known about the relationship between matrons’ participation in this plan and hospital success in clinical governance fulfillment. This cross-sectional, analytic-descriptive study was conducted to investigate the relationship between matrons’ knowledge, attitude, and performance in clinical governance and Mashhad hospitals'' fulfillment of clinical governance. A researcher-made questionnaire was used for data collection on matrons’ knowledge, attitude, and performance. The standard checklist of the health ministry and observation were used to assess hospital clinical governance fulfillment. Data was analyzed at the hospital level by SPSS16. The mean scores of matrons'' knowledge, attitude, and performance were above average. Matrons'' attitude towards clinical governance achieved the highest mark (4.46). There was no significant correlation between matrons'' knowledge/attitude/performance and hospital scores for clinical governance fulfillment (P>0.05). While the levels of matrons'' knowledge, attitude, and performance were satisfactory, there is still a need for improving matrons'' knowledge. Absence of any statistically significant relationship between matrons'' knowledge, attitude, performance and hospitals scores for clinical governance fulfillment may be due to the study small sample size.