جستجوی مقالات مرتبط با کلیدواژه « بیمارستان آموزشی » در نشریات گروه « پزشکی »

Medications are the most common therapeutic intervention, and the safe use of medication and the existence of processes to improve the safety of medicine are of prime importance. Since nurses have a major role in implementing medication orders, they play a vital role in promoting safety and reducing medication harm to patients. Therefore, the present study was conducted to determine the barriers to reporting medication errors by nurses of teaching hospitals affiliated with Gorgan, Iran, in 2021.

In this cross-sectional study, 340 nurses from Gorgan teaching hospitals were selected by a randomized stratified method in 2021. The data collection tool was a demographic information checklist and a valid questionnaire of barriers to reporting medication errors. The collected data was analyzed using SPSS software (version 16). Moreover, descriptive statistics, Kolmogorov-Smirnov tests, Spearman, Mann-Whitney, and Kruskal-Wallis correlation coefficients were used.

The average age of the nurses was 33.11 ± 7.36 years, and 290 (85.3%) participants were female. The average score of reporting obstacles in the area of "fear of management factors" was higher than other areas (3.20±0.50), followed by the areas of "fear of reporting consequences" (3.17±0.35) and "factors related to the reporting process" (2.87±0.63) were in the next ranks. The highest average in the areas of "fear of the consequences of reporting", "factors related to the reporting process" and "fear of managerial factors", were respectively related to "fear of legal issues" (3.94±1.11), "unclear definition of medication error" (3.54±1.05), and "disproportionality of the officials' reaction with wrong hierarchy of importance" (3.75±0.96). The service sector had a significant relationship with the overall score of barriers to reporting medication errors (P=0.020) and the area of fear of managerial factors (P=0.017) in a way that the barriers to reporting medication errors by the nurses of the Emergency Department were higher than the other parts.

Among all reporting barriers, "fear of legal issues" had the highest score. Due to the existence of factors such as fear of judicial issues and the inappropriate reaction of hospital officials, it is suggested to define the error reporting process and how to handle medication errors and train hospital managers on how to deal with the person at fault.

The learning environment is a behavioral determinant and the student's understanding of the environment is very important in learning and clinical education. The DREEM model is used as a diagnostic tool to identify the difference between the real environment and the desired environment. The purpose of this study is to investigate the opinions of medical students and their professors about the quality of the clinical learning environment.

This cross-sectional study was done between 2021 and 2022 and the views of 233 medical students (assistants, interns and externs) and faculty members was gathered using the DREEM questionnaire in five areas of student perception of learning, professors, educational atmosphere, scientific ability, and social conditions. SPSS 27 was used to analyze the data.  
 

Mean score of the clinical education status in the main wards of the educational center was 120.00±23.07 of 200 Mean score of students’ perceptions of learning was 26.85±7.22, perceptions of teachers (28.49±4.53), academic self-perception (19.06±4.70), perception of the academic atmosphere (29.54±6.37), and social self-perception (16.06±4.29).Assistant professors and associate professors considered the condition of the clinical learning environment of the hospital more favorable than interns (0.006 and 0.002, respectively) and externs (0.019 and 0.006, respectively).

Educational environment of Akbar hospital was evaluated as favorable in all areas. This shows the high attention of professors to the principles of educational design and the creation of appropriate educational space. However, to further improve quality, the DREEM model can be used to monitor and measure modification and change in clinical education program.

Medical schools and teaching hospitals cooperate in achieving the common goals of education, research, and health services, which are in the form of policies, rules, and regulations, memoranda. The purpose of this study is to determine the areas of professional interaction between medical schools and teaching hospitals. Determining the driving factors and inhibiting factors of these interactions was at the Iran University of Medical Sciences.

Methods and Material: 

The present study was conducted using a qualitative approach in 1400. The participants in this study were 16 experts from the Iran University of Medical Sciences who had a background in management at the university. Data collection was done through semi-structured interviews and the Thematic analysis method was used to analyze the interviews.

Reviewing previous research and analyzing interviews, professional interactions between medical school and teaching hospitals in 7 main areas including education and research, governance, budget and finance, human resources, health services, space and physical equipment, and supply chain. , With 17 components, 22 inhibitory factors, and 22 propellants, the results were extracted and summarized.

The findings of the study showed that medical schools and teaching hospitals in education and research through educational planning, clinical education, and research planning and development, governance in the components of supervision, accountability and structure, budget and finance in the field of allocation Training budget and training costs, in human resources for faculty members, staff and learners, in providing health services in treatment protocols, in physical resources and equipment in the training space and training equipment section and in the supply chain regarding the supply of training items and supply Educational services have professional interactions that if there are any deterrents or drivers in the interactions, there is a possibility of disruption or improvement in professional interactions between the two institutions.

Safety culture is the basis and dominant part of patient's safety, and is considered as the main axis of safety promotion programs and service quality. The purpose of this study was to explain the challenges of safety culture in Iranian educational centers with a qualitative approach.

This study was a contractual qualitative content analysis which conducted in 1400. The study population consisted of people who had 5 years of experience in taking care patient or working in the patient's safety and quality control unit in teaching and medical centers affiliated to Tehran University of Medical Sciences. Study data were saturated by purposeful snowball sampling and in-depth and semi-structured interviews with 25 participants. “Granheim and Landman approaches” and “Goba and Lincoln criteria” were used to analyze the data and solidify the research. The process of coding and analyzing research data was performed simultaneously; Finally, the extracted categories and subcategories were confirmed by the interviewees. MaxQDA 10 was used to analyze data.

By analyzing the interviews, 331 codes, 7 categories and 20 subcategories were extracted. Lack of reporting errors, poor culture regarding no-blame, staffing issues, low understanding of patient safety, poor management support for patient safety, poor teamwork between units, and lack of open organizational communication were the main categories found and the most important challenges of safety culture in teaching and medical hospitals.

According to the findings of the research, developing codified and continuous educational programs, strengthening teamwork and communication, adopting a comprehensive approach to increase the presence of all members of the treatment team in the process of reporting, and analyzing and implementing error prevention programs are among the requirements for improving and promoting the safety culture and quality of service to patients.

Training skilled doctors and the benefit the medical students receive from education, especially clinical education, depends on the realization of the goals of medical schools and teaching hospitals, which is achieved through communication and interaction between these two institutions in medical universities. These interactions are established through different policies, laws, regulations, and memorandums. This study aimed to determine the current status of professional interactions between the medical school and teaching hospitals in Iran University of Medical Sciences.

The present study was carried out in 2021 using a quantitative approach, in terms of practical purpose, descriptive method, and data collection method. Individuals from research areas, officials of the medical school, officials of the teaching hospitals, and the officials of the Iran University of Medical Sciences were selected for sampling. A total number of 105 individuals were questioned. A researcher-made questionnaire was used to collect data. Data analysis was performed using SPSS software.

According to the data analysis, the current status of professional interactions between the medical school and teaching hospitals in different areas of interaction were as follows (0 is the lowest and 10 is the highest): education and research: 5.68, governance: 4.79, financial budget: 3.83, human resources: 4.74, provision of health services: 4.55, physical resources and equipment: 4.76, and supply chain: 4.27.

Considering the current state of interactions between the Faculty of Medicine and teaching hospitals of Iran University of Medical Sciences, it was necessary to improve these interactions. Faculty members’ attention to education, adjustment of frequent treatment practices, referral of learners to teaching hospitals according to a specific program, definition of joint research projects, revision of organizational structure and powers, allocation of the required budget, holding joint workshops for employees of two institutions, fair payments, optimal application of space and educational equipment, as well as setting up dynamic monitoring systems played an important role in promoting the interactions of the two institutions.

A local outpatient clinic for diagnostic, therapeutic and counseling of patients without the need for hospitalization, which provides a variety of educational opportunities for learners. Considering the role of outpatient clinics in medical education, this study was conducted with the aim of promoting the education of trainees, interns and specialized and sub-specialized assistants of Mashhad University of Medical Sciences in the clinic of Imam Reza Hospital in 1399.

 The present qualitative study was conducted in the clinic of Imam Reza (AS) Hospital in Mashhad in 2016 with a content analysis approach. The study population consisted of managers of Imam Reza Hospital, faculty members and medical students, a total of 60 people were purposefully selected. In this study, focused interviews and group discussions were used to collect information. Content analysis method was also used to analyze the study data.

 Based on the findings of this study, at first, the current process of patient appointments and visits was identified. After that, the most important problems and executive shortcomings in the current process were discussed. The findings of the present study showed that the patient visit process in the teaching clinic of Imam Reza Hospital with problems such as inability to follow patients, inability to determine the exact time of attendance The patient faces the clinic, the accumulation of students in the visiting rooms, the lack of examination based on clinical standards, the lack of adequate educational facilities such as computer systems and examination equipment, and the lack of special subspecialty clinics and referral centers for special patients. Also, the most important solutions for removing administrative obstacles were identified. After reviewing the proposals, due to time and financial constraints; The following corrective measures were taken: improving educational facilities, modifying the queuing process, designing an in-hospital referral system, managing queues for patients, and setting up special clinics and sub-specialized referrals.

In this article, we tried to improve the quality of education in one of the main educational clinics in Mashhad. Review and reform of educational processes in the field of outpatient services should be on the agenda of managers and planners of hospitals and educational clinics; Because medical education in the context of outpatient services is one of the main educational infrastructures.

The study of educational environments in teaching hospitals has been recommended by many countries on an ongoing basis. In medical science education environments, in order to organize students' behavior, it is necessary to adjust and adapt the content and educational environment to each other as two important factors in the development of medical sciences. The aim of this study was to determine and study the atmosphere of teaching hospitals in Abadan University of Medical Sciences from the perspective of clinical students and its relationship with the performance of managers.

the present cross-sectional study was conducted in educational hospitals under the auspices of Abadan School of Medical Sciences in 2019. Research tools were two valid and reliable questionnaires. The “Dundee Ready Educational Environment Measure questionnaire” was used for the educational environment and the “managers' performance questionnaire” was used to evaluate the managers of the departments. Sampling was done by census and 204 students and 32 heads of clinical departments were included in the study. The collected data were analyzed using descriptive tests (frequency and percentage, mean and standard deviation) and analytical tests of t-test, analysis of variance and Pearson correlation.

The performance of managers was strong (mean score was 68.75±7.39). Each of the different areas of managers' performance had a positive and significant relationship with each other. Educational atmosphere was also favorable (mean score 113.35±22.59). There was no significant relationship between educational atmosphere and managers 'performance and each of the managers' performance areas.

Due to the dissatisfaction of one third of students with the educational atmosphere in Abadan University of Medical Sciences in clinical departments and not so high score in the dimension of planning in the performance of managers, educational processes need careful planning and implementation of standards.

Violence in the hospital is a common phenomenon. Among the hospital staff, nurses are at greater risk of exposure to violence. The purpose of this study was to investigate the exposure to workplace violence in nurses and its related factors.

This descriptive-analytical study included 309 nurses working in the teaching hospitals affiliated with Kurdistan University of Medical Sciences in 2016. We collected data using a modified workplace violence questionnaire. Chi-square and Fisherchr('39')s exact tests were used for data analysis. A P-value of less than 5% was considered significant.

The results showed that the most frequent type of violence was verbal (79%). Also, exposure to physical violence had statistically significant relationships with age, sex, marital status, work experience, and working hours (P>0.05). There was also a statistically significant relationship between age and inpatient ward with verbal violence and also between age, sex, work experience, and inpatient ward with bullying (P>0.05).

The results showed that nurseschr('39') exposure to workplace violence was high and the risk of exposure to violence decreased with age and higher work experience. Therefore, measures such as training courses on proper communication with patients and colleagues and improvement of coping skills for stressful and violent situations are recommended

Cost analysis is a management tool that helps the researchers to identify and manage high costs. The purpose of the present study was to calculate the cost of day bed and patient bed in the ear, nose, and throat departments of a teaching hospital and a private hospital in Yazd City, Iran.

The present descriptive, analytical, and retrospective study was conducted in the ear, nose, and throat departments of a teaching hospital and a private hospital in Yazd in 2016. Data were collected by studying the relevant documents and checklists. Data were analyzed using Excel software.

The costs of day bed occupancy were calculated as 7286715 rials and 2386715 rials in the ear, nose, and throat departments of the private and educational hospitals, respectively. The cost of a private hospital day bed was much higher than that of a training hospital considering the tariff approved in 2016. Income per patient per day was obtained as 2204643 rials in educational hospital and 1500130 rials in the private hospital. The income per patient per day was higher in the teaching hospital than the private hospital.

Hospitals should have a precise financial system in order to manage the day bed pricing based on the final costs and have realistic day bed costs. Given the high cost of staffing, hospitals should pay close attention to control these costs. Hospitals also need to adopt appropriate processes to consume the consumables logically and reduce their costs.

The present study examines the status of documenting the death certificate in the intensive care unit of the selected hospitals of Mashhad University of Medical Sciences.

This applied research was conducted by combining quantitative and qualitative methods in four stages. At first, the death certificate checklist was created by reviewing the relevant literature and its validity and reliability were assessed. The death certificates issued in the surgical intensive care unit of selected hospitals were then examined. In the third phase, Focus Group documentarians were asked to document the causes of the defect during the focus group sessions. Finally, the results of the steps of the findings were presented to a panel of experts to find the most appropriate solutions.

15 related articles were reviewed out of 76 recovered articles (19.7%). After reviewing the above texts, 4 general areas were identified. The mean score of the direct cause error was 49 and the underlying cause error was 40.5. The reasons for the error were the ambiguity of the physicians in the 19 cases of referral, low motivation, and low awareness of the necessity and manner of completing the death certificate. Strategies for evaluating and responding to documentarians were to formulate general and specific guidelines for completing death certificates for different departments based on the frequency of absurd diagnoses in the workshop.

Applying the strategies of this study can lead to a reduction in ineffective referral to forensic medicine, more accurate completion of the death certificate in hospital.

Emergency medicine specialty has been established in Iran since 2001 due to the need to create a specialized field for responding to patients' vital needs. Since this is a young field and challenges have arisen since the creation of this field, we have studied the importance, needs and challenges of emergency medicine specialists being available in a teaching hospital. This study was a qualitative one. In this study, purposeful sampling was performed among experienced experts in the field of emergency medicine, the founders of this field, and authorities of the healthcare system. The mentioned groups were interviewed in a semi-structured manner and the sample size was determined via data saturation. Finally, the important codes were selected in groups and subgroups and then analyzed. In this study, after interviewing 12 experts in the field of emergency medicine, information saturation was reached. One of the most important needs for establishing emergency medicine specialty was found to be the need for an expert with a comprehensive view for treatment of critical patients and a comprehensive management for emergency department; and the greatest challenges were financial interference with other disciplines and interference in the area of joint work. Considering the evaluations of the present study and more than 2 million patients and injured people presenting to the emergency department each month, the presence of an emergency medicine specialist in educational hospitals is recommended.

According to World Health Organization, patient safety is a serious public health issue, an important aspect of the quality of health care, and a vital prerequisite for universal health coverage. The objective of this study was to investigate nurseschr('39') perceptions of patient safety culture (PSC), barriers to medical error reporting, as well as the relationship between the two.

This descriptive-analytical study was conducted in six public hospitals in Tehran on 420 nurses who were selected using multistage sampling. The Hospital Survey on Patient Safety Culture (HSOPSC) and a researcher-made questionnaire on barriers to medical error reporting were utilized. Data were analyzed using correlation tests, t-test, analysis of variance (ANOVA), and multivariate regression analysis using SPSS software (version 20).

The mean score of patient safety culture was 52.01 and the mean score of barriers to error reporting was 3.13. Manager expectations and actions had the highest mean score (69.8) and non-punitive response to errors had the lowest mean score (23.6) among the dimensions of patient safety culture. Fear of the consequences of reporting an error was the most important perceived barrier to error reporting (3.37). There was a significant negative correlation between safety culture and perceived barriers to error reporting (P<0.001).

Setting up an anonymous reporting system as well as increasing managerschr('39') support for error reporting and providing positive feedback to nurses are essential steps to improve error reporting.

Our country is facing increasing costs of treatment and funding shortages. The reason for this crisis is the increase in the cost of medicine, medical equipment, and skilled manpower. The physiotherapy unit is one of the cost centers and accounts for a large share of hospital costs. Managers and policymakers must pay special attention to cost centers in order to make decisions about reducing costs and increasing efficiency.

The present study was a retrospective economic evaluation that was conducted in 2018 based on activity-based costing. The data were collected by referring to the Physiotherapy, Employment, Finance, Medical Equipment and Warehouse Units. To calculate the cost of physiotherapy services, the salaries of staff working in the units as well as the cost of the consumables, depreciation of buildings and equipment and energy were estimated in detail.

The total annual costs of the physiotherapy unit amounted to 8415722668 rials and the annual loss of the mentioned unit amounted to 1287632108 rials. The highest costs were for physiotherapists, accounting for 82% of the total costs, overhead costs, accounting for 8.1%, and depreciation of medical equipment.

According to the losses imposed on physiotherapy unit, one of the suggested options is unit outsourcing. Running evening shifts, paying fee-for-service due to high personnel costs, and hiring a non-faculty technical manager with a lower salary can be effective in reducing the average unit cost.

Productivity and performance improvement of human resource, as the most valuable asset and resource in the organization, have a greater impact on success and productivity of the organization than any other factors. The purpose of this study was to evaluate the dimensions of human resource productivity based on ACHIEVE model among personnel of hospitals affiliated to Iran University of Medical Sciences.

This descriptive-analytical cross-sectional study was performed on 358 clinical and nonclinical personnel in 15 teaching hospitals of Iran University of Medical Sciences in 2019, selected by stratified relative randomized sampling. To collect data, the standard ACHIEVE questionnaire was used. Data analysis was done using one-way ANOVA, T-test and Tukey post hoc and through SPSS version 22 software.

Mean score of human resource productivity was 2.8 which was in a moderate condition. The highest and lowest mean scores of productivity were respectively related to environment (3.38) and motivation (2.30) dimensions. There was a significant difference in productivity based on gender, occupational group and educational level.

It seems that creating performance-based management systems and fair rewards and benefits systems, as well as continuous performance appraisal sessions between employees and their supervisors could be effective in increasing motivation.

Moral intelligence is one of the most important factors influencing the improvement of quality of hospital care. Therefore, to develop a suitable tool for nurses is essential. The purpose of this study was development and psychometric evaluation of "Nurses' Moral Intelligence Scale" in Kerman University of Medical Sciences Hospitals.

The present study is a methodological study. Initially, with a comprehensive review of the literature on moral intelligence and the opinions of 15 experts in Delphi method after four rounds, nurses' moral intelligence domains were extracted. Then, using the concept of each component, items "Nurses' Moral Intelligence Scale" were developed and its content validity was evaluated by 22 experts. The scale was distributed among 400 nurses working in Kerman University of Medical Sciences hospitals. Its construct validity was measures using exploratory factor analysis. Internal consistency (Cronbach's alpha) and test-retest methods were used to measure reliability. Data were analyzed using SPSS-20 and Amos-24 software.

Initially, 29 factors were identified for moral intelligence that gained 9 consensus experts in the four Delphi rounds. The designed scale also had 41 items, which reduced the number to 34 by examining content validity by experts and removing 7 items. In exploratory factor analysis, 9 factors and 34 items were confirmed. The reliability of the instrument was measured using the Cronbach's alpha coefficient and test-retest, 0.961 and 0.861 respectively.

The "Nurses' Moral Intelligence Scale" with 9 factors and 34 items has acceptable validity and reliability. It is suggested that researchers use the developed scale in their studies.

Today, due to changes in health care services, including the use of Updated technologies, differences in people's demands and needs, change in patterns of diseases, increasing public awareness, the necessity of applying an ethical approach is increasingly felt. Therefore, this study was designed to assess the level of ethical development of nurses in Mashhad hospitals and compare it among nurses in teaching and private hospitals.

In this descriptive-analytical study, 198 nurses were selected by the census sampling from 4 private and teaching hospitals in Mashhad. Informed consent was obtained from each participant included in the study. The data collection tool was Kohlberg standard questionnaire. Data were analyzed using SPSS version 16 statistical software. P-value<0.05 was considered significant.

The average age and mean work experience of nurses were 35.86±7.80 and 7.73±7.03 respectively. The average score of NP was 45.29±6.84 and the mean CP score was 20.9±3.91 in nurses and there was no significant difference in private and teaching hospitals. Also, except in the intensive care unit there was not a significant relationship between demographic factors and these scores. Ethical Considerations: Participants' informed consent and compliance with the principle of confidentiality were considered.

According to the results, it was found that the level of ethical development score is higher than the average score but far from the optimal level. Most of the nurses are at the level of the post conventional and conventional, but a significant number are at the pre-conventional level. On the other hand, considering the effect of professional environment and performance of the nurses on students modeling and learning, it is expected that promotion of ethical aspect of professional nurses, especially in teaching hospitals, will be the priority of nurses’ empowerment programs. Also it is a necessity to monitor and evaluation of Nurses’ performance.

Ethical values act as the most powerful factors influencing citizenship behaviors. This research was conducted to investigate the relationship between ethical climate and organizational citizenship behavior in nurses of hospitals affiliated to Shahid Beheshti University of Medical Sciences.

This descriptive-analytical study was performed on 307 nurses selected through random sampling in 2016. Data gathering tools were two questionnaires of ethical climate and organizational citizenship behavior. Data analysis was done through SPSS20 and using descriptive statistics, t-test, One- Way ANOVA, correlation and multiple regression tests.

Mean scores of ethical climate and citizenship behavior were respectively 3.51 ±0.55 and 3.49 ± 0.45 that reflects the favorable view of nurses towards ethical climate and citizenship behavior. Head nurses had the highest mean scores in the dimensions of ethical climate. Among the dimensions of citizenship behavior, the dimension of conscience gained the highest mean score among nurses. There was a significant relationship between employment status and ethical climate (P<0.001) and also a positive and significant correlation between ethical climate and citizenship behavior (P<.0.001).

Promotion of ethical climate enables nurses to respond better to ethical stress, to adapt to other causes of workplace dissatisfaction and consequently showing citizenship behaviors. Some meetings are required to be held in order to improve the relationship between physicians and nurses, to create alignment and understanding among staff and consequently to improve citizen behaviors.

Department of Nutrition is one of the most important parts of a hospital that has a significant role in patient's satisfaction. Managers' attention to the quality of nutrition services reduces hospital costs. This study was conducted to identify the challenges of the nutrition department of a selected teaching hospital.

The present study was a qualitative study done with phenomenological approach in 2018. Purposeful sampling and snowball sampling were used. Data collection was done through semi-structured interview.  Participants were 25 individuals involved in the nutrition department of the selected teaching hospital in Kerman. Finally, data analysis was done using framework analysis.

The identified challenges were classified into 7 main codes and 21 sub-codes. Main codes were the contracts and tenders, staff supervision, financing, operational line monitoring, human resources, quality of food and physical space. 

Paying attention to the hospitals’ nutrition departments is one of the main factors in patients' recovery and an inseparable part of the treatment process. Therefore, hospital managers and policymakers should pay particular attention to this part and to improve the nutrition department status of the hospitals through reviewing and modifying contracts and tenders, staff supervision, financing, queue monitoring and providing sufficient human resources, high quality food and required physical space.

Hospital, as one of the most important organizations for health promotion, requires efficient and effective human resources. Health information management staffs are responsible for storing, processing, and distributing information used to improve the quality of healthcare services. This study aimed to investigate the relationship between quality of work-life and productivity of health information management staff.

This descriptive analytical cross-sectional study was conducted on 165 staffs of health information management department in an educational hospital of Isfahan in 2017.  The data were collected using Walton Work Quality life Questionnaire and Gold Smith's Manpower Productivity Questionnaire. Data were analyzed using descriptive and analytical statistics, including Pearson correlation coefficient, independent t-test, Spearman correlation coefficient, analysis of variance and linear regression analysis by SPSS 18.

Average scores for the quality of work life and productivity were 2.65 ± 0.51 and 2.64 ± 0.42, respectively. According to one-sample t-test, these scores had a significant difference with the moderate level (p < 0.05). Based on the Pearson correlation test, the quality of work life had a direct and significant relationship with the productivity of staff (r = 0.73 and p < 0.05). Independent t-test showed that the average score of productivity in men was significantly higher than women (p < 0.05).

Considering the direct and significant relationship between the quality of work life and productivity in the staff of health information management department as well as the low level of these two components, the relevant authorities should take appropriate measures. These approaches include safe physical design of workspace and establishment of a fair payment system in accordance with the working conditions of this department. The quality of work life should be improved since it affects the quality of service delivery and staff productivity.