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Background: A quality framework for hospital-based physiotherapy is lacking. This study aims to design a framework, building on the currently available literature, to improve the quality of hospital-based physiotherapy., Methods: A multidisciplinary panel of six representatives of hospital-based physiotherapy and their key stakeholders (patients, medical specialists, hospital management and professional association) was set up. We used brainwriting to sample ideas and the 'decision-matrix' to select the best ideas., Results: The first round of brainwriting with an online panel of six experienced participants yielded consensus on seven possible methods for quality improvement of hospital-based physiotherapy [1]: continuing education [2] ,feedback on patient reported experience measures and patient reported outcome measures [3] ,a quality portfolio [4] ,peer observation and feedback [5] ,360 degree feedback [6] ,a management information system, and [7] intervision with intercollegiate evaluation. Placing these methods in a decision matrix against four criteria (measurability, acceptability, impact, accessibility) resulted in a slight preference for a management information system, with almost equal preference for five other methods immediately thereafter. The least preference was given to a 360-degree feedback., Conclusions: In the design of a framework for improving the quality of hospital-based physiotherapy, all seven suggested methods were perceived as relevant but differed in terms of advantages and disadvantages. This suggests that, within the framework, a mixture of these methods may be desirable to even out respective advantages and disadvantages., (© 2023. The Author(s).)

Background: A proper application of the Delphi technique is essential for obtaining valid research results. Medical researchers regularly use Delphi studies, but reports often lack detailed information on methodology and controlled feedback: in the medical literature, papers focusing on Delphi methodology issues are rare. Since the introduction of electronic surveys, details on response times remain scarce. We aim to bridge a number of gaps by providing a real world example covering methodological choices and response times in detail., Methods: The objective of our e(lectronic)-Delphi study was to determine minimum standards for emergency departments (EDs) in the Netherlands. We opted for a two-part design with explicit decision rules. Part 1 focused on gathering and defining items; Part 2 addressed the main research question using an online survey tool. A two-person consensus rule was applied throughout: even after consensus on specific items was reached, panellists could reopen the discussion as long as at least two panellists argued similarly. Per round, the number of reminders sent and individual response times were noted. We also recorded the methodological considerations and evaluations made by the research team prior to as well as during the study., Results: The study was performed in eight rounds and an additional confirmation round. Response rates were 100% in all rounds, resulting in 100% consensus in Part 1 and 96% consensus in Part 2. Our decision rules proved to be stable and easily applicable. Items with negative advice required more rounds before consensus was reached. Response delays were mostly due to late starts, but once panellists started, they nearly always finished the questionnaire on the same day. Reminders often yielded rapid responses. Intra-individual differences in response time were large, but quick responders remained quick., Conclusions: We advise those considering Delphi study to follow the CREDES guideline, consider a two-part design, invest in personal commitment of the panellists, set clear decision rules, use a consistent lay-out and send out your reminders early. Adopting this overall approach may assist researchers in future Delphi studies and may help to improve the quality of Delphi designs in terms of improved rigor and higher response rates.

Introduction: Organisational capacity in terms of resources and care circuits to shorten response times in new stroke cases is key to obtaining positive outcomes. This study compares therapeutic approaches and treatment outcomes between traditional care centres (with stroke teams and no stroke unit) and centres with stroke units., Methods: We conducted a prospective, quasi-experimental study (without randomisation of the units analysed) to draw comparisons between 2 centres with stroke units and 4 centres providing traditional care through the neurology department, analysing a selection of agreed indicators for monitoring quality of stroke care. A total of 225 patients participated in the study. In addition, self-administered questionnaires were used to collect patients' evaluations of the service and healthcare received., Results: Centres with stroke units showed shorter response times after symptom onset, both in the time taken to arrive at the centre and in the time elapsed from patient's arrival at the hospital to diagnostic imaging. Hospitals with stroke units had greater capacity to respond through the application of intravenous thrombolysis than centres delivering traditional neurological care., Conclusion: Centres with stroke units showed a better fit to the reference standards for stroke response time, as calculated in the Quick study, than centres providing traditional care through the neurology department., (Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.)

Abstract Proper hospital waste management poses important concerns due to the risk capacity of hospital waste to health and the environment. Healthcare management approaches have changed in recent years, motivated by the desire to minimize the environmental impact. The review aims to examine the current HCW and considers the local challenges associated with establishing a circular economy (CE) to improve hospital waste management regarding training along Plan, Do, Check, and Act (PDCA). The study found that mean medical and general waste segregation rates in public hospitals were 50.15 and 49.85, respectively. On average, 3.6 kg of waste was generated per bed per day. Analysis revealed a significant correlation between total waste and infectious waste with the number of occupied beds in the hospital (p

Background. Since the ants play a key role in transmitting microorganisms, it is important to identify the fungal species isolated from the external surfaces of ants caught from hospitals. Therefore, the present study aimed to identify the fungal species isolated from the external surfaces of ants caught from Babol hospitals. Methods. Ants were collected by trapping inside sterile tubes and were washed with normal saline for 20 seconds. Then, 100 µL of the resulting solution was cultured in Sabouraud Dextrose Agar (SDA) medium and incubated for one week at 35C°. Macroscopic, microscopic, and RFLP-PCR molecular techniques were employed to confirm the grown isolates. Results. A total of 79 fungal isolates including 47 isolates of hyaline fungi (59.49%) and 32 isolates of black fungi (40.51%) were obtained from 63 captured ants. Out of 47 cultured fungi, 15 fungi (31.91%) were Aspergillus niger and 15 (31.91%) were A. flavus, 12 (25.53%) were A. fumigatus and 5 isolates were Penicillium (10.63%). Conclusion. Taking into account the increasing number of immunocompromised patients, outbreak of COVID-19 in recent years, and numerous reports about the invasive fungal diseases among COVID-19 patients, it was found necessary to control the ants as carriers of these organisms. Practical Implications. It was necessary to control these insects effectively in order to prevent the increasing prevalence of the fungal diseases among the hospitalized people.

Background and purpose: The occurrence of medical errors in healthcare centers is highly significant due to the sensitive nature of providing care and saving patients' lives. Failure to report such errors can result in both financial and moral harm to patients and have adverse effects on the healthcare system. Medical errors have significant clinical and economic consequences and can influence mortality rates. Despite the wide range of medical errors in healthcare delivery, the errors committed by medical staff—due to the close care relationship between them and the patient—are among the most complex issues in the management of treatment systems. Therefore, the purpose of this study was to explore the causes of non-reporting of medical errors in hospitals and methods of encouraging the reporting of such errors. Materials and methods: This qualitative study was conducted using semi-structured, in-depth individual interviews with a conventional content analysis approach. The goal was to identify the factors contributing to the non-reporting of medical errors in 1402 (Iranian calendar year). The study population included doctors, specialists, and providers actively involved in patient safety in the hospital. In other words, individuals with knowledge and valuable experience in this area were interviewed. Data collection was conducted using a semi-structured questionnaire, designed by reviewing the literature and with the assistance of expert professors for the interviews. Sampling was performed purposefully until data saturation was reached. Data saturation was achieved after interviewing 22 experts. After the interviews, items and sub-items were identified through content analysis. Results: Key factors contributing to the failure to report medical errors were identified in two themes, six categories, and 45 items. The extracted themes included organizational and management factors, as well as legal issues. Organizational and management factors encompassed organizational culture, communication, reporting, and monitoring, while legal factors involved the consequences of reporting and control mechanisms. In total, 38 solutions were proposed to encourage the reporting of medical errors. The experts' suggestions for strategies to promote error reporting were identified under two themes, six categories, and 38 items. The themes included organizational and management factors and legal issues. Organizational and management factors covered organizational culture, the reporting process, monitoring, and communication, while legal factors involved the consequences of reporting and control. Conclusion: Errors in medical procedures may occur due to the inherent nature and sensitivity of these procedures. However, it is essential that medical staff consider themselves obligated to minimize errors and reduce harm to patients. Studying the causes of non-reporting of medical errors and understanding the underlying reasons are critical for improving patient safety and the quality of healthcare services. This knowledge can assist policymakers and healthcare practitioners in making informed decisions about error reporting and in delivering higher-quality services to the public. Additionally, it is important to train medical teams on the various types of errors and how to appropriately address them.

Abstract Background A voluntary National Healthy Food and Drink Policy (the Policy) was introduced in public hospitals in New Zealand in 2016. This study assessed the changes in implementation of the Policy and its impact on providing healthier food and drinks for staff and visitors in four district health boards between 1 and 5 years after the initial Policy introduction. Methods Repeat, cross-sectional audits were undertaken at the same eight sites in four district health boards between April and August 2017 and again between January and September 2021. In 2017, there were 74 retail settings audited (and 99 in 2021), comprising 27 (34 in 2021) serviced food outlets and 47 (65 in 2021) vending machines. The Policy’s traffic light criteria were used to classify 2652 items in 2017 and 3928 items in 2021. The primary outcome was alignment with the Policy guidance on the proportions of red, amber and green foods and drinks (≥ 55% green ‘healthy’ items and 0% red ‘unhealthy’ items). Results The distribution of the classification of items as red, amber and green changed from 2017 to 2021 (p

Background & Aims: Musculoskeletal problems can develop due to the work conditions of nurses and laboratory technicians. The purpose of this study was to evaluate how much time nurses and laboratory technicians spent on high strain postures. Materials & Methods: This cross-sectional study was performed on 32 nurses (from internal medicine and general surgery wards) and 20 laboratory technicians in a hospital located in Tabriz, northwestern Iran. The Nordic questionnaire and the rapid entire body assessment (REBA) method, with a new scoring algorithm, were used for ergonomic assessment. The 90th percentile was calculated for REBA components to determine the time spent by participants working in stressful postures in the upper extremity, upper quadrant, and trunk/lower extremity. One-way analysis of variance was used for statistical analysis. Results: Musculoskeletal symptoms of the neck (63.5%) and back (55.8%) were the most common. The time spent in high strain postures of upper extremity and trunk/lower extremity was statistically different between nurses and laboratory technicians. Internal medicine nurses and laboratory technicians were observed in high strain postures for 11% and 8% of their work hours, respectively. Conclusion: Internal medicine nurses are subjected to more biomechanical stress than general surgery nurses, particularly in the upper body. On the other hand, laboratory technicians work with biomechanical stress on their trunk and lower extremities. Ergonomic interventions are proposed to correct nurses' upper body postures and laboratory technicians' lower body postures.

Background: In most developing countries, data on the prevalence and distribution of paediatric endocrine disorders is lacking. Objective: To describe the pattern of endocrine disorders seen in the Department of Child Health, University of Benin Teaching Hospital (UBTH), Benin City, Nigeria between 2004 to 2013. Methods: In this retrospective study, the case files of children seen in the paediatric endocrinemetabolic clinic and those admitted into the wards at the UBTH, Benin City from January, 2004 to December, 2013 were audited. Information obtained included age at presentation, gender, principal complaints, and final diagnosis. For those who were admitted, the outcome was noted. The hospital’s paediatric clinic register was examined to obtain the total number of new cases seen during the period under review. Results: A total of 13,735 new cases were seen in the Department of Child Health, UBTH during the ten-year period under review and 99 (0.72%) of these had endocrine disorders. The frequencies of the four leading groups of endocrine disorders seen were as follows: diabetes mellitus 17.2%; disorders of sex development 13.8%; disorders of the thyroid gland 12.1%; and disorders of energy balance 11.2%. Short stature was a rare presenting complaint. Conclusion: Diabetes mellitus and disorders involving sex development, thyroid gland, energy balance and pubertal development were the five leading groups of childhood endocrine disorders encountered in our clinical practice in UBTH.

Introduction: Globally, acute watery diarrhoea is a major cause of childhood morbidity and mortality. It is the fourth leading cause of death in children contributing as high as 11% of all childhood deaths. In Nigeria, acute watery diarrhoea causes 240,106 deaths per year. Out of pocket expenditure is a major source of healthcare funding in Nigeria, hence treatment of acute watery diarrhoea places extra financial burden on the families especially those in the low socio- economic class. Objective: To determine the cost of treatment of acute watery diarrhoea in children aged 6 to 36 months. Methodology: This was a cross- sectional study conducted on children aged 6-36 months who presented with acute watery diarrhoea from January through October 2017. Data obtained using interviewer-administered questionnaire, included socio- demography, duration of illness, treatment cost of the index diarrhoeal episode before presenting to our facility, transportation cost, food and other incidental cost, duration of hospitalization. Diagnostic tests requested and medications prescribed were obtained from the patient’s medical file. Information on drug cost, diagnostic test cost and hospital bed day cost were obtained from Nnamdi Azikiwe University Teaching Hospital (NAUTH) central pharmacy, NAUTH main laboratory and account section respectively. Statistical Package for Social Sciences (SPSS) version 20 was used for data analysis. Result: Seventy two patients were recruited for the study, of whom 47(65.0%) were males giving a male female ratio of 1.9:1. Forty eight (66.6%) of the study participants belonged to the lower socioeconomic class while 22(30.6%) and 2(2.8%) belonged to the middle and upper socioeconomic class respectively. A mean total treatment cost per diarrhoea episode derived from this study was #37,572.2 ± #12,479.0 which at the time of the study was equivalent to US$ 104.7 ± US$ 34.8. This is well above the then Nigerian minimum monthly wage of 18,000.0 (US$ 50.1). Conclusion: The result of this study showed that the economic burden of acute watery diarrhoea is quite enormous especially to the low socio-economic group. Prevention and improvement of home treatment of diarrhoea may reduce the treatment cost.

Abstract The health sector is one of the components of development, social welfare and economic growth. The purpose of this study was to develop an economic evaluation model of the environmental and health costs of occupational diseases by hybrid approach. To achieve the study goal, a taxonomy of economic evaluation model of the environmental and health costs of occupational diseases has been developed. The Delphi method was used to identify health and environmental criteria and the analytic network process (ANP) method was used to weigh the sub-criteria. Finally, health and environmental cost were estimated based on the available information. Naft Subspecialty Hospital in Tehran, Iran (NSHT), was selected as the place of case study. In this study, eight and eleven sub-criteria were identified in the health and environmental sector, respectively. The ANP results indicated that the medicine and medical equipment cost criteria with a weight of 0.312 in the Medical sector, and the special and infectious waste cost criteria with a weight of 0.085 in the environmental sector were the most significant cost criteria in NSHT. Furthermore, the parametric model findings indicated that 99.84 and 0.16% of the total costs are associated with health and environmental costs, respectively. The findings indicated that 61.3% of the costs of the health sector were associated with the two sectors of medicine and medical equipment and the cost-of-service personnel, and 91.7% of the costs of the environmental sector are associated with wastewater treatment and the cost of electricity consumption. This study tried to present a quantitative model of the health and environmental costs of NSHT. Implemention of this integrated model can be a practical and effective step in allocating resources and prioritize interventions.

BACKGROUND: Nowadays, attention to patient safety is important in providing hospital services, and any failure to do so can have adverse consequences. Safety is one of the most salient rights of patients when receiving health services. The purpose of this study was to evaluate personnel perspectives on patient safety culture in Shahid Beheshti Hospital in Hamadan, Iran. METHODS: This descriptive cross-sectional study was carried out on 101 medical personnel of Shahid Beheshti Hospital in Hamadan in operating rooms, intensive care, endocrine surgery, pulmonary, and emergency surgery in December 2019. Patient Safety Culture Survey Standard Questionnaire was used to assess patient safety culture. The first part of the questionnaire contained demographic information and the second part contained 42 questions. The results were analyzed by SPSS software. RESULTS: 27.7% of the study participants were operating room personnel. 36.6% (n = 37) of personnel were men and 63.4% (n = 64) were women. In terms of attitude toward patient safety in different parts of the hospital, the operating room received the highest score (143), and the emergency room the lowest score (124). CONCLUSION: Increasing attention to the patient safety culture will lead to the development and advancement of the country's hospitals and will lead them to a patient-friendly hospital. Moreover, the lower average dimensions in this study should be considered in order to enhance these dimensions.

Background: Diagnostic thinking and clinical competence are the two main domains of efficient nursing care. This study assessed the association between diagnostic thinking and clinical competence among emergency nurses. Methods: The present correlation study was conducted in 2020 on 113 nurses working in emergency departments in a northwestern province of Iran over two consecutive years. A stratified random sampling method was used for recruiting nurses. Data was gathered via a demographic questionnaire, the Diagnostic Thinking Inventory, and the Nurse Competence Scale and analyzed using the SPSS 18 software. Pearson's correlation assessed the association between the nurses' diagnostic thinking and clinical competence at a significance level of 0.05. Results: According to the findings, the nurses’ diagnostic thinking abilities were poor (154.15 ±15.73, range of 150-155), while their clinical competence was good (61.62±18.97, range of 51-75). Significant correlations emerged between thinking flexibility, work role (r=0.22, p=0.017), and memory structure. In addition, thinking flexibility was significantly associated with work role (r=0.22, P=0.017), and memory structure was correlated with teaching-coaching function (r=0.22, P=0.015), diagnostic functions (r=0.25, P=0.006), management of situations (r=0.45, P=0.0001), therapeutic interventions (r=0.42, P=0.0001), regimens (r=0.18, P=0.056), and work role (r=0.4, P=0.0001). Conclusion: Amplifying thinking procedures and using diagnostic thinking patterns enhance emergency nurses' practice, performance, and clinical competence and promote nursing care. Lecturers and planners must employ modern educational methods to increase nurses' thinking skills and clinical competence.

Aim. The aim of this study was to evaluate adherence to spironolactone in a group of unselected patients with arterial hypertension by analysis of measured serum spironolactone and canrenone concentrations according to a proposed two-step decision scheme based on pharmacokinetic considerations. Materials and Methods. Simulation of serum concentration-time profiles of spironolactone and canrenone based on population pharmacokinetic parameters described in literature and a body weight-normalized spironolactone dose / canrenone level nomogram derived from a group of adherent patients with conservatively treated primary hyperaldosteronism, were used to create a two-step decision scheme. 71 outpatients treated with spironolactone for resistant hypertension with spironolactone and canrenone serum concentrations measured between 2018 and 2021 were analyzed according to the proposed scheme. We compared our proposed methodology to the standard approach for adherence testing. Results. With the most sensitive traditional approach to adherence assessment through detectable serum concentrations of spironolactone and/or canrenone, 9 (12.7%) non-adherent patients were identified. With our two-step assessment of adherence, we were able to identify 18 (25.4%) non-adherent patients. Conclusion. Consideration of the pharmacokinetic properties of parental drug and its metabolite led to improved sensitivity in non-adherence detection in patients with arterial hypertension. This approach enables better interpretation of measured spironolactone and canrenone serum concentrations and should be used in clinical practice.

Objective(s): Hospital staff performance in management positions significantly affects cost-effectiveness, service productivity, and the hospital’s success. Evaluating management performance at different levels could identify their strengths and weaknesses and discover their training needs. The current study aims to evaluate the performance of hospital managers in Ahvaz, Iran. Methods: In this cross-sectional study, which was conducted in 13 public (teaching and non-teaching) and private hospitals, 11 top managers and 162 middle and operational managers were selected using census and stratified sampling methods, respectively. The data was collected by a questionnaire. The questionnaire consisted of two sections: demographics and the study main variables (planning, decision making, organizing, coordinating, communicating, controlling, leadership and budgeting). The data were analyzed using the 23rd version of the SPSS software. Results: The mean and standard deviation of the planning, decision-making, organizing, coordinating, communicating, leadership, controlling, and budgeting were (3.91±0.75), (3.98± 0.64), (4.06±0.71), (4.05±0.67), (4.03±0.62), (4.00±0.74), (3.99±0.67), and (2.99±1.21) respectively. In general, the mean overall performance of Ahvaz hospital managers was 3.88 out of 5. The best reported were in organizing and coordinating, and the weakest were in planning and budgeting performance. Conclusion: In general, the self-reported performance of Ahvaz hospital managers was relatively good. However, more training, especially in planning and budgeting, is suggested.

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ABSTRACT Objective: To validate a risk rating scale for triaging of cancer patients in emergency rooms that can identify individuals needing urgent care or in imminent worsening of the clinical condition. Methods: This is a health instrument validation study developed in the emergency care ward of a Brazilian hospital, a referral center for cancer and hematological diseases. We built the Emergency Oncology Scale (EMOnco) based on literature review and a Delphi survey with 20 experienced oncologists (physicians and nurses). We validated the scale by assessing its construct validity, interobserver agreement and reliability after applying them in a convenience sample of all consecutive patients with cancer who visited the ward between August 2017 and January 2018. We compared the EMOnco Scores with those from other scales, used by six trained nurses: the Emergency Severity Index, the Manchester Triage System, and the Karnofsky Performance Status. We also recorded socio-demographic and clinical features and the Sequential Organ Failure Assessment (SOFA) results in the intensive care unit. Results: We included 250 patients with locally advanced or recurrent disease and undergoing chemotherapy. EMOnco screening took 2.24 (± 2.9) minutes in average. The interobserver correlation coefficient was 0.9. EMOnco was highly correlated with Emergency Severity Index (r=0.617) and also correlated with Karnofsky Performance Status (0.420) Manchester Triage System (0.491; p

Background Antimicrobial use in Laos is among the highest in Southeast Asia. The first Lao comprehensive antimicrobial prescribing guidelines have been available since 2021. This study explored the determinants of antibiotic prescribing decisions and how the new prescribing guidelines were being used. Methods In August 2022, in-depth interviews were conducted with 16 Lao prescribers from two hospitals. Participants were questioned about their prescribing behaviours, attitudes to guidelines, how they learned about the guidelines and factors influencing their uptake. The interviews were audio-recorded, transcribed, and translated into English. Thematic analysis of the transcripts was conducted. Results Lao prescribers considered multiple factors before deciding to prescribe antibiotics to their patients. The most common factor was based on the clinical judgement of the prescribers. Lack of certain antibiotics and turnaround times of laboratory results were the main challenges to prescribing antibiotics appropriately. The majority of participants were satisfied with the guidelines, regarding them as comprehensive, simple and convenient. However, most participants admitted that they did not access the guidelines very often. The main reason was that they could remember the treatment recommendations because they treat similar diseases on a daily basis. Improving antibiotic knowledge was the most common recommendation in order to improve the appropriate use of antibiotics. Raising awareness of the guidelines and promoting their use should also be considered. In addition, heads of the wards, and policy and implementation leaders, should support, monitor and feedback their use to encourage all prescribers to follow the guidelines. Conclusions Several factors contribute to enhancing appropriate antibiotic prescription. Key factors for improving antibiotic prescription include enhancing prescribers' clinical knowledge, ensuring access to essential antibiotics, and updating guidelines regularly. Health leaders must get involved to promote their use.

The McGill Journal of Medicine (MJM) Podcast Series, MJM MedTalks, interviews members of the medical and health sciences community from McGill, and beyond to gain insights into their careers, research, advocacy, and more. This series aims to enhance knowledge sharing between experts and trainees in the medical field. In this episode, Renée-Claude Bider, a Master’s student in medical physics and Podcast Associate at the McGill Journal of Medicine, interviews Prof. Annmarie Adams, who is jointly appointed in McGill University's School of Architecture and the Department of Social Studies of Medicine. Dr. Annmarie Adams trained as an architect and architectural historian at UC Berkeley. Her research focuses on how medicine, gender, and architecture intersect. In the first part of their conversation, Bider and Prof. Adams discuss the history of hospital architecture, starting in the late 1800s and focusing on Montreal and Canadian institutions, including the Royal Victoria Hospital, Montreal Neurological Institute, Montreal General Hospital, The McGill University Health Centre (Montreal, Canada), Sick Kids (Toronto, Canada) and McMaster Children’s Hospital (Hamilton, Canada). In the second part of their conversation, Bider and Prof. Adams discuss the architecture of specialized healthcare spaces, such as long-term care homes, birthing suites, palliative care, and cancer centers. They end their conversation by discussing Prof. Adams' ongoing research into the life of influential physician Maude Abbott and advice for trainees in the medical field. A glossary of terms, a content overview, a list of relevant links and research articles, supplementary images from Prof. Adams’ collection, and a transcript of the interview are included in the show notes for this episode.

Increasing population and healthcare costs make changes in the healthcare system necessary. This article deals with ChatGPT's perspective on the future role of radiologists in the AI-driven hospital. This perspective will be augmented by further considerations by the author. AI-based imaging technologies and chatbots like ChatGPT can help improve radiologists' performance and workflow in the future AI-driven hospital. Although basic radiological examinations could be delivered without needing a radiologist, sophisticated imaging procedures will still need the expert opinion of a radiologist. [ABSTRACT FROM AUTHOR]

Background and purpose: Musculoskeletal disorders (MSDs) are becoming increasingly prevalent as a source of occupational disability injuries. Musculoskeletal disorders in midwives are a major concern, as midwifery is one of the professions with a high risk of occupational diseases, in addition to risk factors such as awkward posture, repetition of movements, heavy workload, fatigue, and stress, are also dependent on individual-organizational factors, which can be caused by occupational tensions and may lower the quality of care provided to mothers and newborns. Because there is little research in this field, the current study aimed to determine the prevalence of musculoskeletal disorders among midwives working in public and private hospitals in Sari City, as well as the influence of related risk factors on it. Materials and methods: This descriptive-analytical cross-sectional study was conducted in 2023 (summer) among midwives working in public and private hospitals in Sari City as a census. 193 workers in maternity wards were chosen, with having more than one year of experiencea nd the exclusion being a history of musculoskeletal disorders. The data collection tool included a demographic and organizational information collection form, the Cornell musculoskeletal disorders questionnaire. This questionnaire looks at 12 body areas and the frequency, severity, and impact of discomfort on work abilities throughout the previous working week. Data analysis was done by SPSS statistical software, descriptive statistics, chi-square, and independent t-tests at a significance level of 0.05. Results: The mean and standard deviation of the age and work history of the studied subjects were 35.60±7.74 and 10.42±6.84, respectively. Analysis of the frequency of musculoskeletal problems revealed that the most commonly affected areas were the wrists, shoulders, lower back, and neck. Meanwhile, 79.4% of people have experienced discomfort in at least one of the various organs. In terms of the amount of pain, the highest average pain sensation among participants was reported the highest average pain intensity at night (40.7%). Based on the results, the highest prevalence of MSDs was found in the neck region (58.4%), followed by the lower back (57.6%), shoulder (53.9%), and then one or both wrists (51%). Also, the average age and history of midwives with MSDs had a significant relationship (P

Abstract Collaborative innovation between hospitals and biomedical enterprises is crucial for ensuring breakthroughs in their development. This study explores the structural characteristics and examines the main roles of associated key actors of collaborative innovation between hospitals and biomedical enterprises in China. Using the jointly owned patent data within the country’s healthcare industry, a decade-long collaborative innovation network between hospitals and biomedical enterprises in China was established and analyzed through social network analysis. The results revealed that the overall levels of collaborative innovation network density, collaborative frequency, and network connectivity were significantly low, especially in less-developed regions. In terms of actors with higher degree centrality, hospitals accounted for the majority, whereas a biomedical enterprise in Shenzhen had the highest degree centrality. Organizations in underdeveloped and northwest regions and small players were more likely to implement collaborative innovation. In conclusion, a collaborative innovation network between hospitals and biomedical enterprises in China demonstrated high dispersion and poor development levels. Stimulating organizations’ initiatives for collaborative innovation may enhance quality and quantity of such innovation. Policy support and economic investments, strategic collaborative help, and resource and partnership optimization, especially for small players and in less-developed and northwest regions, should be encouraged to enhance collaborative innovation between hospitals and the biomedical industry in China and other similar countries or regions.

Background: Defining the emergency nursing approach to trauma patients and identifying deficiencies is crucial for providing effective, fast, safe, and high-quality emergency nursing care in the future. This study aimed to describe the nursing activities of emergency nurses working in a tertiary university hospital in the province of Samsun, located in the Eastern Black Sea Region of Türkiye, regarding the emergency nursing approach to trauma cases over a 1-year period. Methods: The research was conducted with a mixed method using data from 2018. Both qualitative and quantitative methods were employed to define the emergency nursing approach to trauma cases in the emergency department (ED). Data were collected through a retrospective review of medical records of trauma patients (N=2540) in the ED and focus group discussions with 10 emergency nurses. The data extracted from the medical records of ED trauma patients were compared in terms of compliance with the emergency nursing job descriptions specified in the Nursing Regulation (NR) and the Emergency Nurses Association (ENA) emergency nursing guide. Quantitative data were reported using frequency and percentage, while content analysis was performed for qualitative data. Content analysis involved coding, identifying themes, and organizing data according to the codes and themes that were determined. Results: The study revealed that ED nurses primarily assessed vital signs (81.5%) and consciousness (34.8%) and focused on activities related to the circulatory system (56%) in their nursing interventions. The research also indicated that the nurses' knowledge regarding the primary and secondary evaluation of emergency patients was insufficient. Although not currently a requirement in Türkiye, nurses expressed that obtaining emergency nursing education should be a prerequisite for working in the ED. Conclusion: The study found that ED nurses in Türkiye lacked a systematic guideline for approaching trauma patients, and there was inadequate adherence to ENA guidelines in practice. Additionally, independent nursing interventions that enhance the influence, visibility, and autonomy of the nursing profession were not being implemented in the ED.

Background and purpose: Since 2013, Iran's health system reform has been implemented at the national level with goals such as increasing people's access to health services, reducing direct payments to patients, and improving the quality of services. As this initiative has been associated with significant changes in the financing of hospitals, this study aims to investigate the changes in income and expenses of public hospitals in Mazandaran province, as two important indicators of key hospital financial performance, before and after the implementation of the reform. Materials and methods: This is a retrospective study that was conducted in 2018. Since this study deals with the impact of the intervention carried out by the public sector by comparing the changes before and after the implementation of the intervention, it is therefore considered a type of quasi-experimental study. The statistical population includes all government hospitals in Mazandaran province. The sampling method was census and covered all 24 public hospitals of Mazandaran province. The time frame of the study covers from 2009 to 2016, that is, 4 years before and 4 years after the implementation of the reform. Secondary data that is routinely recorded in the information system of the country's hospital system has been used in this study. To collect the data, a researcher-made checklist was used based on the objectives of the study and the availability of data in the routine information recording system of hospitals, which mainly included the variables of staff cost, non-staff cost, cash income, insurance income, and working year. After collecting the data from the comprehensive and centralized Electronic Information System (HIS), which contains all the financial and functional information of all hospitals in the province, the data were extracted and analyzed using SPSS software and appropriate statistical methods. Results: In general, after the implementation of the reform, the average costs in the studied hospitals increased from 249,613 to 771,552 million Tomans (2.61 times) and the average incomes increased from 152,738 to 534,804 million Tomans (3.50 times). Therefore, both the average cost and the average income in the 4-year periods before and after the implementation of the initiative have generally increased, but the growth rate of costs and incomes in the period before the implementation of the reform was lower than the period after its implementation, although, in the same period, the gap between expenses and incomes has been widening. In the period after the implementation of reform, due to the rapid increase in income at the beginning of the implementation, the gap between cost and income has decreased relatively, but gradually the rate of income growth has decreased compared to the rate of cost growth, and as a result, the gap between the cost and income of the hospitals studied in the end of the study period has experienced an unprecedented gap. It has also been found that during the years of the study, the staff cost has continued to rise with more or less trends, while the non-staff cost has started to decrease sharply and unprecedentedly since 1995. Conclusion: Although the implementation of the reform has increased the financial turnover of government hospitals, due to the increase in the average cost compared to the increase in their average income, the implementation of this plan has increased the financial pressure on the hospitals and widened the income deficit compared to their cost. Therefore, the gap between cost and income and the rising trend of this gap in government hospitals can be a challenge for funding hospitals and guaranteeing the relative access of people to these services now and in the future.

Objective(s): Health equity is “the availability of health services and people's access to them, using health services based on need, paying for health services based on financial ability and having an acceptable level of health”. Equitable distribution of hospital beds plays a significant role in achieving universal health coverage and improving people's health. This study aimed to measure the equity in the geographical distribution of hospital beds in Tehran province, Iran. Methods: Data for this descriptive and cross-sectional study was collected from the Ministry of Health and the Iranian Statistics Center. All hospitals in Tehran province were included in this study in 2016. Lorenz curve and Gini coefficient were used to calculate the equity of hospital beds distribution using the Excel software. Results: Tehran province population was 13,267,637 at the study commence. There were 158 hospitals with 25,866 beds in Tehran province in 2016 (1.2 hospital per 100,000 people and 1.9 hospital beds per 1000 people). Tehran, Varamin and Firoozkooh cities had the highest hospital beds per population. Tehran, the capital, had 90% of the total Tehran province hospitals and 95% of the hospital beds. The Gini coefficient for hospital bed distribution among Tehran cities was 0.299. Conclusion: The distribution of hospital beds in Tehran Province was relatively fair. Equitable allocation of hospital beds particularly in less developed cities is necessary for achieving health equity in access to health resources.

Objectives Occupational stress is a common complaint in nurses, who perceived more sense of effort-reward imbalance (ERI). Suboptimal health status (SHS) is a state between health and disease. However, the correlation between ERI and SHS is unclear. Therefore, the aim of this study was to examine the prevalence of SHS and ERI and evaluate the relationship between ERI and SHS in clinical nurses by a cross-sectional study. Material and Methods The current cross-sectional study was conducted through an online survey at Dongping People’s Hospital in China. A total of 633 completed surveys were received. Effort-reward imbalance was measured by subscales of the ERI questionnaire. SHS was measured by the Suboptimal Health Status Questionnaire – 25 (SHSQ-25). The relationship between ERI and SHS in nurses was subsequently assessed by Spearman’s correlation coefficient and logistic regression model. Results The mean age of the optimal health status (OHS) group (M±SD 26.3±7.3 years) was younger than the SHS group (M±SD 30.3±6.9 years). The prevalence of SHS was 54.5% (345/633). Female nurses aged ≥30 years, a junior college or university graduate educational level, smokers, and nurses without regular exercise were at a higher risk of SHS. In Spearman’s correlation analysis, ERI reflected by the effort-reward ratio was correlated with SHSQ-25 score (r = 0.662, p < 0.001). In logistic regression, ERI was strongly associated with SHS after potential confounding factors adjusting (OR 27.924, 95% CI 22.845–34.132). Conclusions The prevalence of SHS was significantly high in clinical nurses. Administrators should pay more attention to health status of female nurses aged ≥30 years, with a junior college or bachelor’s degree, smoking, and without regular exercise to reduce the SHS and ERI. Int J Occup Med Environ Health. 2024;37(2):166–75

Abstract Background The National Health Service in England aims to implement tobacco dependency treatment services in all hospitals by 2024. We aimed to assess the uptake of a new service, adapted from the Ottawa Model of Smoking Cessation, and its impact on 6-month quit rates and readmission or death at 1-year follow-up. Methods We conducted a pragmatic service evaluation of a tobacco dependency service implemented among 2067 patients who smoked who were admitted to 2 acute hospitals in London, England, over a 12-month period from July 2020. The intervention consisted of the systematic identification of smoking status, automatic referral to tobacco dependence specialists, provision of pharmacotherapy and behavioural support throughout the hospital stay, and telephone support for 6 months after discharge. The outcomes were (i) patient acceptance of the intervention during admission, (ii) quit success at 6 months after discharge, (iii) death, or (iv) readmission up to 1 year following discharge. Multivariable logistic regression was used to estimate the impact of a range of clinical and demographic variables on these outcomes. Results The majority (79.4%) of patients accepted support at the first assessment. Six months after discharge, 35.1% of successfully contacted patients reported having quit smoking. After adjustment, odds of accepting support were 51–61% higher among patients of all non-White ethnicity groups, relative to White patients, but patients of Mixed, Asian, or Other ethnicities had decreased odds of quit success (adjusted odds ratio (AOR) = 0.32, 95%CI = 0.15–0.66). Decreased odds of accepting support were associated with a diagnosis of cardiovascular disease or diabetes; however, diabetes was associated with increased odds of quit success (AOR = 1.88, 95%CI = 1.17–3.04). Intention to make a quit attempt was associated with a threefold increase in odds of quit success, and 60% lower odds of death, compared to patients who did not intend to quit. A mental health diagnosis was associated with an 84% increase in the odds of dying within 12 months. Conclusions The overall quit rates were similar to results from Ottawa models implemented elsewhere, although outcomes varied by site. Outcomes also varied according to patient demographics and diagnoses, suggesting personalised and culturally tailored interventions may be needed to optimise quit success.

Background Sensor technology could provide solutions to monitor postures and motions and to help hospital patients reach their rehabilitation goals with minimal supervision. Synthesized information on device applications and methodology is lacking.Objectives The purpose of this scoping review was to provide an overview of device applications and methodological approaches to monitor postures and motions in hospitalized patients using sensor technology.Methods A systematic search of Embase, Medline, Web of Science and Google Scholar was completed in February 2023 and updated in March 2024. Included studies described populations of hospitalized adults with short admission periods and interventions that use sensor technology to objectively monitor postures and motions. Study selection was performed by two authors independently of each other. Data extraction and narrative analysis focused on the applications and methodological approaches of included articles using a personalized standard form to extract information on device, measurement and analysis characteristics of included studies and analyse frequencies and usage.Results A total of 15.032 articles were found and 49 articles met the inclusion criteria. Devices were most often applied in older adults (n = 14), patients awaiting or after surgery (n = 14), and stroke (n = 6). The main goals were gaining insight into patient physical behavioural patterns (n = 19) and investigating physical behaviour in relation to other parameters such as muscle strength or hospital length of stay (n = 18). The studies had heterogeneous study designs and lacked completeness in reporting on device settings, data analysis, and algorithms. Information on device settings, data analysis, and algorithms was poorly reported.Conclusions Studies on monitoring postures and motions are heterogeneous in their population, applications and methodological approaches. More uniformity and transparency in methodology and study reporting would improve reproducibility, interpretation and generalization of results. Clear guidelines for reporting and the collection and sharing of raw data would benefit the field by enabling study comparison and reproduction.

Background: Hospitalisation can be a traumatic experience, where inpatients are exposed to an abundance of physical and psychological stressors. Evidence suggests that these hospital-related stressors negatively impact health: a phenomenon known as post-hospital syndrome. The current study aimed to identify hospital-related stressors, and to develop and provide initial validation for a new measure of in-hospital stress.Methods: Measure development occurred in three stages: (i) semi-structured interviews, (ii) item generation, and (iii) pilot testing. Twenty-one patients were interviewed regarding their recent hospital experiences, and a list of hospital-related stressors was produced. These stressors were compiled into a questionnaire and piloted on 200 recent inpatients to provide initial evidence of internal consistency and construct validity.Results: Stressors identified from the interviews captured all relevant questions from three previous hospital stress measures, plus 12 more. The most reported stressor was ‘poor sleep’. These hospital-related stressors were developed into 67 questions, forming the Hospital Stress Questionnaire (HSQ). The HSQ showed excellent internal consistency and construct validity, and correlated with feelings of vulnerability and being unprepared to go home.Conclusion: The HSQ is a promising self-report tool for measuring in-hospital stress. Future research ought to investigate its psychometric properties further in larger and more diverse samples. The measure has potential to be used to monitor patient risk of post-hospital syndrome.

The healthcare sector is constantly changing due to many different factors, both external and internal, such as regulatory, organizational, technological, personnel, financial, and geopolitical change. Change management methods and tools are useful for effectively planning, implementing and monitoring change. The important issue is in which areas and to what extent change management is utilized in healthcare. The aim of this text is therefore to conduct a scoping literature review on change management in healthcare and to develop, based on the results of this research, a theoretical model of determinants and motives for implementing change management in healthcare. A scoping review of the literature was conducted to determine the extent to which change management is applied in healthcare organizations. Texts meeting the inclusion criteria were searched for in four databases: PubMed, Embase, Scopus, and EBSCO. The search was limited to texts published in English. Of the 247 publications screened, 73 met the inclusion criteria. Additionally, 1021 keywords were selected from the screened publications, of which 137 met the inclusion criteria and were approved for the keyword analysis. The keywords formed seven thematic clusters: human, change management, organization and management, leadership, healthcare delivery, hospital management, and productivity. There are a number of motives for using change management in healthcare, and all centre around a few determinants that can be divided into those directly related to the specifics of the healthcare sector and those directly related to management processes. These determinants and motives were included in the theoretical model. [ABSTRACT FROM AUTHOR]

Abstract Background Best practice of infection prevention and control (IPC) is a hallmark for the patient care in health care settings, but it is a major problem in developing countries like Ethiopia where resources are limited. Ethiopia Federal Ministry of Health working to strengthen its IPC program, but still it there is no organized study conducted on assessment of performance gaps and implementation challenges of IPC practice faced by hospital staffs particularly among sanitary workers (SWs) at public hospitals inline to national and international guidelines. Aim This study focuses on compliance and determinants of IPC among sanitary worker in public hospitals in eastern Ethiopia: A cross sectional study design. Method A cross‐sectional study was conducted among 809 SWs and eight IPC experts in public hospitals, eastern Ethiopia, from May to August 2023. A standard questionnaire was used to collect data. Face‐to‐face interview was conducted. Ten (10) question pursued to answer YES/NO were prepared. The cut point for categories of IPC practice was 1: Good (16–20 scores), 2: Fair (10–15 scores), and 3: Poor (

Abstract Objectives Hospitals must maintain their effective operations during and after disasters. Due to the current increase in disasters, hospital resilience has drawn scholarly attention. This study aimed to review studies on the changes in the definition of hospital resilience after COVID‐19, build a conceptual framework for careful measurement, and identify the main dimensions of hospital resilience emphasized during the COVID‐19 pandemic. Design The initial phase of this study was a systematic review of articles published before the COVID‐19 pandemic to extract the hospital resilience‐related dimensions for the second phase. The second phase involved text‐mining articles published both before and after the emergence of COVID‐19. Setting In the systematic review phase, 12 databases were searched from 2006 to January 2020, including Scopus, Web of Science, MEDLINE through PubMed, Embase, ERIC, ProQuest, the Cochrane Library, Emerald, Springer, Science Direct/ELSEVIER, Google Scholar, and SID (for Persian language papers). Then, after COVID‐19, articles published in these databases between January 2020 and May 2022 were evaluated using text mining. Result During the systematic phase, 17 out of 1530 papers published before COVID‐19 were synthesized to collect components of hospital disaster resilience. These identified components were the inputs for the text‐mining phase. The text mining on pre‐COVID papers resulted in six clusters, with the highest weight (0.65) belonging to general resilience and disaster preparedness, while in the post‐COVID text mining phase, including 70 papers, 8 clusters have been identified, with the highest weight cluster (0.78) focusing on the mental and psychological aspects of resilience among healthcare workers. Conclusion Following the COVID pandemic, scholarly attention has shifted to the more personal dimensions of hospital resilience, including psychological resiliency. It seems necessary for policymakers to focus more on the individual and psychological resilience of hospital staff.

Abstract Background and Aims Considering the increasing use of information technology (IT) and the need of the implementation of related projects, the lack of IT specialists in the health system is one of the major challenges that require planning and foreseeing. This study was conducted with the aim of predicting the number of required IT personnel in hospitals of Isfahan University of Medical Sciences based on the modeling of identified and weighed influential factors in 2023. Method First, Delphi method and multi‐criteria decision‐making (MCDM) using the Expository Posthaste Effective Resemblant Tool (ExPERT) were conducted to identify and weigh the components that affect IT staff's workload in hospitals. Then, the model for predicting the required number of IT personnel for the involved hospitals was developed. In all stages, the obtained information and results were checked and confirmed using experts' opinions in Focus Group Discussions. Results Twenty‐one hospitals (57%) out of 37 hospitals are facing a shortage of IT personnel. This varies from 0.5 to 1.6 personnel in different hospitals. Thirteen hospitals (35%) were reported to have adequate IT staffing and three hospitals (8%) had excess IT staffing. Conclusion This study provided a predictive model for required IT staff in hospitals using MCDM through ExPERT which can be used in cases where the use of workload‐based methods such as Workload Indicators of Staffing Need is complex or time‐consuming.

Background: The presence of nurses plays a crucial role in ensuring patient safety and delivering necessary nursing care. This study aimed to explore the process of nurses' presence at patients' beds in cancer wards. Methods: Employing a grounded theory approach, this qualitative study was conducted in a cancer ward, involving 34 participants including nurses, patient companions, and hospital staff. Participants were purposefully selected for their involvement. Interactive interviews were conducted for data collection, and data analysis followed the approach proposed by Corbin and Strauss in 2015. Results: The data analysis revealed the core category of "Striving to be with the patient", which encompassed the following axial categories: "Challenges of accompanying patients with diverse needs" (Context), "Striving to be with the patient" (Process), "Motivational factors driving the desire to be with the patient"(Mediating facilitator), "Difficulties encountered in maintaining patient presence"(Mediating inhibitor), and "Mixed feelings of satisfaction and sorrow accompanying the presence" (Outcome). Conclusion: Nurses in oncology wards demonstrate tremendous dedication as they strive to maintain a delicate equilibrium between their own emotional well-being and the diverse needs of their patients. This task can be highly demanding, but through the implementation of customized strategies and drawing inspiration from personal sources, these nurses effectively navigate the emotional challenges associated with patient care.

ABSTRACT OBJECTIVE: To explore the correlation between socio-demographic factors and the incidence of workplace violence. METHODOLOGY: This was a Cross-sectional research design study, effectively integrating quantitative and descriptive methods. The data collection period took place in August of 2023. This approach facilitated an exhaustive data collection, subsequently analyzed statistically and presented in a narrative format. Researchers used three statistical tests, Pearson correlation, Spearman rank, and Chi-square analyses, to examine the correlation between variables. The study comprised 433 hospital nurses who met the established inclusion criteria. The data was collected using standard questionnaires that underwent thorough validation and reliability testing to ensure accurate results. The investigation was carried out with the aid of IBM SPSS v.26. RESULTS: A comprehensive analysis found that solely the attributes of the working area (0.00) and the protocols for reporting WPV (0.017) exhibited a noteworthy correlation with the quantity of WPV occurrences reported by nurses in Aceh Province. Other variables failed to demonstrate a significant correlation, with p-values spanning from 0.122 to 0.928. CONCLUSION: To enhance the safety and well-being of employees, it is crucial to consider their sociodemographic backgrounds. Education, training, protection, and support can help prevent workplace violence. Clear job descriptions, efficient communication, and a structured work environment can promote a healthier workplace. Prioritizing every team member's safety and overall wellness is vital in fostering a thriving work culture.

Masalah pelayanan rumah sakit salah satunya antrian merupakan hal yang penting karena mempengaruhi produktivitas rumah sakit. Atrian rumah sakit dapat disebabkan karena banyaknya pasien serta lamanya penanganan pasien. Menurut Peraturan Menteri Kesehatan Republik Indonesia Nomor 30 Tahun 2022, standar kepuasan pasien terhadap pelayanan kesehatan harus mencapai ≥ 90 % dimana salah satu indikatornya yaitu lama waktu tunggu. Lamanya waktu tunggu atau antrian dapat menyebabkan pelayanan medis menjadi kurang maksimal terutama pada pasien yang memiki keluhan darurat (Prabowo, 2019). Oleh karena itu, untuk meningkatkan produktivitas pelayanan rumah sakit dilakukan perancangan sistem diagnosis kesehatan manusia melalui screening digital berbasis desktop application menggunakan metode forward chaining dan neural network untuk memudahkan dokter dalam mendiagnosa penyakit pasien. Pada inovasi ini juga dilengkapi dengan deteksi tingkat keparahan dan rekomendasi pengobatan kepada pasien. Tujuan dari penelitian ini yaitu menciptakan model pengetahuan yang dapat memprediksi penyakit pasien. Hasil dari penelitian ini yaitu didapatkan tingkat akurasi pengujian diagnosis penyakit pasien mencapai 86,6% dengan kemampuan fungsional aplikasi diagnosis yang dirancang dapat berfungsi 100%. Dengan adanya inovasi ini, diagnosis gejala penyakit manusia dapat dilakukan secara tepat dan tepat sehingga produktivitas rumah sakit dan derajat kesehatan pada setiap masyarakat di Indonesia meningkat.

Introduction and purpose: Considering the impact of work stress on nurses' quality of life, stress management is of great importance. Therefore, the present study investigated the relationship between these two factors in the teaching hospitals of Shahid Sadougi University of Medical Sciences in Yazd in 2023. Methods: In this descriptive cross-sectional study, the statistical population comprised working nurses, 123 of whom were selected using proportional stratified random sampling. 1981), frequency, mean and standard deviation as well as Pearson correlation test, t-test and ANOVA were used for data analysis with SPSS version 26 software. Results: Among the dimensions of job strain, nurses had the highest stress (8.38 ± 4.97) and the lowest (2.31 ± 2.09) in the dimension of suffering and death of patients. In the dimensions of quality of work life, the highest mean score was in desire and motivation to work (15.28 ± 2.21) and the lowest in problem solving (8.65 ± 2.54). According to the results of the present study, there is a statistically significant relationship between occupational stress and the quality of nurses' work life (P-value

Background: Noise pollution is a serious issue that faces healthcare centers. It is associated with detrimental effects on both the patient's and the healthcare provider's mental and physical well-being. It could also negatively impact the physician's decision-making. Aim: There are no similar studies conducted in the past 5 years in Saudi Arabia. This is the first study to measure noise levels and deem them pollutants in an emergency care center in Saudi Arabia. Method: This cross-sectional study was conducted in the emergency department (ED) of a tertiary care hospital to assess the level of noise pollution. Noise levels were evaluated in the ED by using a calibrated decibel meter device in three selected units including resuscitation, acute care, and pediatrics unit. Noise levels were only measured during weekdays. In each unit, readings were obtained over 24 hours. Results: Over 24 hours, measurements of all assessed units showed that noise levels exceeded WHO guidelines for hospitals, which recommend sound levels below 40 decibels (dB). Among all clinical areas, the pediatric unit exhibited the highest noise spike (97.3 dB), followed by the resuscitation unit (88.5 dB), and the acute care unit (87.3 dB). Conclusion: Noise levels were high in all the assessed units, which places the patient's well-being and recovery at risk. Moreover, high noise levels could contribute to adverse outcomes for the healthcare provider. More studies should focus on assessing the noise levels in other departments and the efficacy of different intervention methods. [SJEMed 2023; 4(2.000): 087-091]

The aim of this study is to evaluate the effect of noise in hospitals on healthcare workers, to develop recommendations for reducing noise in hospitals and to show why healthcare workers should be protected from noise exposure in hospitals. The study included a total of 80 healthcare workers from different units of the hospital who volunteered to participate. Two participants were excluded for sensorineural hearing loss and the results of 78 respondents were analyzed. Participants were evaluated using a questionnaire created by the researchers. Noise in different units of the hospital was measured during daytime working hours using the Sound Level Meter application with an iPhone 13® smartphone. Measurements yielded a mean noise level of 37.62 dBA (a minimum of 24.21 dBA to a maximum of 67.31 dBA). On occasions, noise levels in the hospital were as high as 74 dBA. Healthcare staff included in the study usually complained of moderate levels of noise and reported noise affected their performance. High levels of noise in hospitals negatively affect healthcare workers' performance. Healthcare workers' awareness about the impact of noise exposure in hospitals should be increased through in-service training programs. Improving noise levels in hospitals and implementing noise reduction interventions can help increase healthcare workers' performance and eliminate the negative impacts of noise exposure to the inner ear. [Med-Science 2023; 12(4.000): 1232-6]

Background/Objectives: Operating room (OR) efficiency is a critical factor in healthcare delivery, influenced by various components including surgical duration, room turnover, staff availability, and equipment preparation. Optimizing surgical start times through systematic strategies such as computational algorithms can significantly enhance OR utilization and management. This study aimed to improve OR efficiency by effectively managing and optimizing surgical start times using a computational algorithm designed to allocate resources more efficiently. Methods: A comparative analysis was conducted over two six-month periods from January to June 2023 and January to June 2024, with an improvement phase implemented between July and December 2023. Results: These measures encompassed training surgical personnel, strengthening the medical team, revising work procedures and hospital regulations, and the integration of a computational algorithm to better schedule and manage surgical interventions. Following the implementation of these comprehensive measures, enhanced management of surgical start times was observed. A statistically significant increase in surgical interventions between 8 and 10 a.m. was noted for the entire OR, rising from 28.65% to 32.13%. While OR occupancy between 8 and 12 a.m. increased from 63.91% to 73.30%, this difference was not statistically significant. However, a notable improvement in average occupancy between 9 and 11 a.m. was observed, rising from 87.53% to 98.07%. Conclusions: The introduction of computational algorithms significantly improved operating room efficiency, particularly in managing surgical start times. Additionally, team coordination improved as a result of more structured scheduling processes. The results indicate that effective management of surgical start times, especially when enhanced by computational algorithms, can positively impact OR utilization, particularly within specific time blocks.

An analysis of patient satisfaction in the context of healthcare reflects the patient’s perception of actual care through the prism of their expectations of ideal care. A study was conducted to investigate patient satisfaction with postoperative care in the context of improvements in hospital medical services (renovations and modernization of operating rooms and wards with beds, endowments in medical equipment for investigation and treatment, new work procedures, and revisions of existing procedures). Statistical analysis was performed based on the questionnaires distributed to patients hospitalized in the surgical wards of the Bihor County Emergency Clinical Hospital, between 2019 and 2023. A total of 4018 questionnaires were collected, and after the elimination of questionnaires with incomplete or incorrect data, 3985 remained in the analysis. Of the total of 2994 people who reported having undergone surgery, a total of 2090 responded to the questions that focused on postoperative care and overall impression of the hospital. No statistically significant differences in patient satisfaction by sociodemographic factors were found. A statistically significant increase in patient satisfaction with postoperative care and overall impression of the hospital was observed over the last 5 years. Correlation testing between postoperative care responses and overall impression, using the Sperman method, shows a directly proportional relationship between the two variables. In the future, it is necessary to extend the patient satisfaction questionnaire to comprehensively analyze the surgical component in order to identify gaps in postoperative care, helping decision makers to improve the medical services provided to patients.

This paper examines how and to what extent the Russian Empire put into practice the European type of medicine in Turkestan in 1865-1917. Furthermore, we compare this process with British India. People of Central Asia had been using folk medicine for treatment since ancient times. In some cases, knowledge of folk medicine was passed from generation to generation through oral information and experiences, while some doctors left their knowledge and experiences in writing. This tradition continued in the region in the late 19th and early 20th centuries. In these years, European medicine entered Central Asia as a competitor to folk medicine. The Russian Empire initially tried to form a system of medicine for medical services to soldiers in Turkestan, and the spread of European medicine among the population was later carried out by the initiative of doctors. [ABSTRACT FROM AUTHOR]

Introdução: O aumento da carga de trabalho dos profissionais de saúde e o grau de complexidade dos pacientes, atribuem maior risco para o estresse psicossocial. Objetivo: Avaliar as associações entre o estresse ocupacional, a qualidade de vida no trabalho e as estratégias de enfrentamento pela equipe de enfermagem hospitalar na pandemia de COVID-19. Métodos: Estudo transversal, quantitativo com amostragem por conveniência, coleta de dados de agosto a dezembro de 2020; em duas unidades da rede hospitalar privada, com questionário sociodemográfico, ocupacional e de saúde; escala visual analógica de avaliação da qualidade de vida no trabalho; Escala de Demanda-Controle-Apoio Social (DCS); Escala de Coping ocupacional. Resultados: A amostra total foi de 196 profissionais de Enfermagem. Houve correlação significativa negativa, porém fraca, entre a dimensão “Demanda” da DCS e QVT (p

Implementing and sustaining technological innovations in healthcare is a complex process. Commonly, innovations are abandoned due to unsuccessful attempts to sustain and scale-up post implementation. Limited information is available on what characterizes successful e-health innovations and the enabling factors that can lead to their sustainability in complex hospital environments. We present a successful implementation, sustainability and scale-up of a virtual care program consisting of three e-health applications (telemedicine, telehome monitoring, and interactive voice response) in a major cardiac care hospital in Canada. We describe their evolution and adaptation over time, present the innovative approach for their “business case” and funding that supported their implementation, and identify key factors that enabled their sustainability and success, which may inform future research and serve as a benchmark for other health care organizations. Despite resource constraints, e-health innovations can be deployed and successfully sustained in complex healthcare settings contingent key considerations: simplifying technology to make it intuitive for patients; providing significant value proposition that is research supported to influence policy changes; involving early supporters of adoption from administrative and clinical staff; engaging patients throughout the innovation cycle; and partnering with industry/technology providers.

Abstract Background and Aims The rapid spread of coronavirus disease 2019 (Covid‐19) led the need to admit a large number of infected people to hospitals in a short period of time, turning them into one of the most important responsive organizations. This study aims to evaluate the performance of selected military hospitals because they carried out a military operation in Tehran in response to the recent pandemic. Methods This is a descriptive‐analytical study. The statistical population of this study consisted of military hospitals responding to Covid‐19 pandemic in Tehran. A checklist to evaluate the performance of hospitals in response to Covid‐19 pandemic (six areas, 23 sub‐areas and 152 items) was used as a data collection tool in this study. This tool had six domains, including risk management and planning, coordination and communication, infection prevention and control, diagnosis and treatment, education and training, and resource management. Results The overall performance of selected hospitals was 63%, which indicated a good performance. The domain of coordination and communication obtained the lowest score. Conclusion The investigated hospitals had good performance because they had a desirable access to resources. Periodic self‐assessment and accreditation is recommended to improve the performance of these hospitals.

Introduction: The US overdose crisis is increasingly characterized by opioid and methamphetamine co-use. Hospitalization is an important opportunity to engage patients in substance use treatment. Understanding characteristics of co-use-related hospital stays can inform the development of services to better support this growing patient population. Methods: We used 2016–2019 National Inpatient Sample data to conduct a cross sectional analysis of hospitalizations involving use of opioids, methamphetamine, or both. We used bivariate analysis to compare patient demographics. We then used multinomial logistic regressions to compare the proportion of hospital stays which indicated co-morbid diagnosis. To account for correlated data, we used generalized linear models to compare outcomes in hospital mortality, patient-directed discharge, and length of stay. Results: Co-use-related stays had a higher proportion of co-morbid mental health (60.7%; 95% CI: 59.9–61.4%) and infectious diseases (41.5%; 95% CI: 40.8–42.2%), than opioid- or methamphetamine-related stays. Co-use-related stays increased between 2016 and 2019 and were associated with a higher proportion of patient directed discharge (10.7%; 95% CI: 10.4–11.0%) and longer length of stay (6.3 days; 95% CI: 6.2–6.4 days) compared to opioid (8.1%; 95% CI: 7.9–8.3% and 5.8 days; 95% CI: 5.8–5.9 days) and methamphetamine-related stays (6.5%; 95% CI: 6.3–6.6% and 5.5 days; 95% CI: 5.4–5.5 days). Conclusion: Patients discharged with co-use differ from patients with opioid or methamphetamine use alone, representing a range of challenges and opportunities. In addition to offering treatment for both substance use disorders, hospital-based services that address co-occurring conditions may better support patients with co-use through targeted and tailored approaches.

Background: Preparation for a crisis is necessary. The experiences of nursing and midwifery professors and students involved in the Covid-19 pandemic have helped us clarify and better prepare for future crises, particularly for biological crises. Therefore, the present research aimed to explore the views and experiences of nursing and midwifery instructors and students regarding in-hospital crisis management during the Covid-19 pandemic.Materials and Methods: In this qualitative study, data collection was done using semi-structured interviews with 14 nursing and midwifery instructors and students with experience in caring for coronavirus patients during the covid-19 pandemic; data analysis was conducted according to the conventional content analysis approach.Results: The analysis of the interviews was accompanied by 425 inference codes, which finally ended in 9 categories and 3 main categories after merging the repeated cases (integrated management, professional ethics and development of specialized knowledge).Conclusion: In order to prepare for biological crises such as the Covid-19 pandemic, the cooperation of various organizations is necessary for a more proper management of the situation. It is also necessary for health managers to recruit workers after assessing the severity of the crisis, and to help them develop their knowledge and skills with evidence-based training, while sticking to the principles of professional ethics, and paying special attention to maintaining and improving the mental health of the workers.

Objective To analyze the blood dispatching of hospitals in Shijiazhuang area, in order to provide reference for blood dispatching policy of hospitals and ensure clinical blood supply. Methods The hospital blood dispatching data from 2018 to 2021 were queried through the blood center information management system (SHINOW9.5) and TMIS system, and the blood dispatching volume, frequency, variety and blood type distribution of hospitals at all levels were analyzed by SPSS statistical software. Results From 2018 to 2021, there were 1 196 times of blood dispatching in hospitals with a total volume of 4 648.5 U, showing a downward and then upward trend two years before and after the outbreak of COVID-19. As the main blood dispatching product, erythrocyte dispatching was 3 988 U, accounting for 85.79% of the total dispatching volume, with a dispatching rate of 2.99‰. The dispatching volume of red blood cells in secondary hospitals accounted for 86.13%.The dispatching rate of erythrocyte in secondary and tertiary hospitals was 1.03% and 0.06%, respectively, with significant difference(P

Abstract Background Nowadays, virtual methods are among the most important and influential marketing instruments in various industries, such as medical tourism. This study aims to investigate the quality of Iranian hospitals’ web pages and their association with the province’s share of the medical tourism industry in Iran and the ownership type of hospitals. Methods In this analytical cross-sectional study, the quality of hospitals’ websites was investigated through a 36-item self-administered questionnaire which was validated, and its reliability was verified (Cronbach’s alpha = 74%.). The questionnaire was categorized into three sections: hospital services and facilities, hospital’s medical tourism-related services, and tourism information of the destination province. The census method was used for data collection. Data analysis was performed using the independent t-test and analysis of variance in SPSS software (version 25), and a P-value

Introduction: Injuries caused by sharp tools are one of the most important biological risks for hospital employees, leading to dangerous physical and psychological consequences. The present study aimed to determine the prevalence of needle sticks and investigate their related factors among the staff of Kowsar Hospital in Semnan. Material & Methods: In this cross-sectional study, all hospital employees who suffered from needle sticks during 2014-2018 were examined. The data collection tool was a checklist, including demographic variables, occupation, type of accident, and measures taken after the needle stick, part of which was collected from the personnel file in the infection control office, and another part was collected through interviews. After collecting the relevant data, they were entered into SPSS software (version 26) and subjected to statistical analysis. Findings: A total of 194 cases of needle sticks occurred, with a prevalence of 23.7%. The mean age of the investigated subjects was 34.57±9.41 years, and 41.2% of cases were in the age group of above 35 years. Moreover, 68% of them were women, 60.3% of subjects worked the morning shift, and most cases of needle sticks occurred in employees with less than five years of work experience (47.9%). Most cases of needle stick (60.3%) were related to employees with bachelor's education and nursing jobs (38.7%). In addition, the highest rate of needle sticks was related to the operating room (28.9%), and insertion of the injection needle into the hand (76.8%) was the most common incident of needle stick, and washing with soap and water (95.4%) was the most common procedure performed after needle stick. Discussion & Conclusion: Considering the relatively high prevalence of needle sticks among the medical staff, hospital officials should take into consideration vaccination and reporting systems while teaching proper prevention methods by creating a safe environment and trying to improve it.