A Daily Diary Approach to the Examination of Chronic Stress, Daily Hassles and Safety Perceptions in Hospital Nursing

Purpose: Stress is a significant concern for individuals and organisations. Few studies have explored stress, burnout and patient safety in hospital nursing on a daily basis at the individual level. This study aimed to examine the effects of chronic stress and daily hassles on safety perceptions, the effect of chronic stress on daily hassles experienced and chronic stress as a potential moderator. Method: Utilising a daily diary design, 83 UK hospital nurses completed three end-of-shift diaries, yielding 324 person days. Hassles, safety perceptions and workplace cognitive failure were measured daily, and a baseline questionnaire included a measure of chronic stress. Hierarchical multivariate linear modelling was used to analyse the data. Results: Higher chronic stress was associated with more daily hassles, poorer perceptions of safety and being less able to practise safely, but not more workplace cognitive failure. Reporting more daily hassles was associated with poorer perceptions of safety, being less able to practise safely and more workplace cognitive failure. Chronic stress did not moderate daily associations. The hassles reported illustrate the wide-ranging hassles nurses experienced. Conclusion: The findings demonstrate, in addition to chronic stress, the importance of daily hassles for nurses’ perceptions of safety and the hassles experienced by hospital nurses on a daily basis. Nurses perceive chronic stress and daily hassles to contribute to their perceptions of safety. Measuring the number of daily hassles experienced could proactively highlight when patient safety threats may arise, and as a result, interventions could usefully focus on the management of daily hassles

Trends in the Causes of Maternal Mortality in Iran and other Countries in the Region During the Years 1990 – 2016

BACKGROUND AND OBJECTIVE: Understanding the causes and frequency of maternal mortality and their occurrence over time is the first important step in policymaking to reduce maternal mortality. The purpose of this study was to compare the trends in the causes of maternal mortality in Iran and other countries in the region including 30 countries. METHODS: In this longitudinal, retrospective cohort study, the trends in causes of maternal mortality between 1990 and 2016 were evaluated. The study data were collected from the Global Burden of Disease Study (GBD) website and a secondary analysis was performed using Multilevel Linear Regression Models. In this study, "time" is the independent variable and "percentage of causes of death" is the dependent variable. FINDINGS: Among the direct causes of death, hemorrhage, despite a significant decreasing trend, was the most important cause of maternal mortality in Iran with a coefficient of 0.28 (CI = -0.25, -0.31, p<0.001). Other direct causes of death, including hypertension, infection, abortion and ectopic pregnancy, labor obstruction, and uterine rupture and death due to delays, all showed a significant decreasing trend during the annual period with regression coefficients of 0.17, 0.16, 0.15, 0.13, and 0.02, respectively (p<0.001). After hemorrhage, indirect causes and deaths due to other reasons were respectively ranked as second and third causes. The trends in almost all causes of death in Iran have declined significantly over this period compared to other countries in the region. CONCLUSION: The results of the study showed that the trends in all causes of maternal mortality has decreased significantly in Iran over the past 26 years, but this decline was lower compared to other countries in the region

Evaluation results of national hospital accreditation program in Iran: The view of hospital managers.

BACKGROUND:Accreditation programs have a crucial role in improving the safety and effectiveness of hospital services. Many factors contribute to achieve accreditation goals. This study evaluated the national Iranian hospital accreditation program from the view of hospital managers in Iran. METHODS:The study was conducted in 2015 using a validated questionnaire designed to collect feedback concerning accreditation processes and impacts. In total, 547 managers were surveyed using a stratified random sampling method. A 5-degree scale Likert from totally disagree=1 to totally agree=5 has been used for the evaluation. Descriptive and inferential statistics were used to analyze the data. RESULTS:Approximately half of hospital managers were satisfied with the accreditation standards and surveying methods. The reason for their dissatisfaction was the high number of measures (2.38). The main challenges to the accreditation method were reported inadequate surveyor training (2.94) their satisfaction with the infrastructure was low because of a lack of hospital resources. Nonetheless, the accreditation program was perceived as being successful in improving patient safety (3.80), patient compliance (3.72), and error reduction (3.53). CONCLUSION:An effective accreditation program requires reducing the number of standards and making them clearer as well as the infrastructure for the implementation of accreditation such as sufficient and sustainable funds, enough human resources and equipment should be provided. Appropriate surveyors should be selected and trained professionally to ensure inter-rater reliability among them