Developing a scale for quality self assessment in pre-hospital emergency services

Establishing of total quality management in any organization including emergency medical services need to an appropriate tool to help developing, implementing and evaluating of quality programs. The objective of this study was to develop a valid and reliable tool for self assessing enabler criteria of Iran EMS centers according to European Foundation for Quality Management (EFQM) model.The study was conducted using the Delphi method, and 43 participants as panelists were enrolled in 3 round modified Delphi technique. Initially, a rating scale was developed in response to main question of study; which items should be contained in self assessing tool of quality in Iran EMS area? This scale was judged by 5 experts primarily, and after some modification was entered in Delphi process. The comments of panelist were collected by E Mail and final scale was developed in the end of 3th rand.Pre-hospital Emergency Self assessing Rating Scale (PHESARS), Was main result of this study that developed in 190 items in 5 enabler criteria according to EFQM model including; Leadership (52), Policy & Strategy (21), staff (41), Resources& partnership (36) and Processes (40).Self assessing scale was developed by TQM and excellence perspective and because of experts' consensus in developing it, has content validity and can be used in self assessing of pre-hospital area and determining improvement opportunity and, can leads the Iran EMS centers to total quality management and organizational excellence

Maternal experience in addict women: a metasynthesis

Introduction: Today, community nurses are challenged by the issues of motherhood, family health, and increased addiction among women. Attention to these issues has been emphasized by many organizations like the World Health Organization (WHO) and United Nations (UN). The aim of the present study was to determine the most recent nursing studies about these phenomena and to create a large compilation of the results of these qualitative studies. Method: This was a metasynthesis of 3 studies on addicted women 2 studies were ethnographies and 1 was a retrospective qualitative research. The sample consisted of 56 women. The Hare and Nobilt procedure was used in the present study. Results: The 5 core concepts obtained included positive attitude toward drugs and fear of the effect of drugs on the child before birth, the feeling of being an addicted mother, ambivalence and the ability to confront suffering, being an ideal mother and decreasing the sense of guilt, affective fibrillation and addiction recurrence due to lack of community and family support. Conclusion: Paying attention to addicted mothers, as the most vulnerable segment of society, and consideration of their experiences will be effective in reducing social problems and success of counter drugs programs. Providing support for these mothers because of numerous physical and mental problems is a priority. The availability of suitable social conditions and support for addicted women will increase the probability of their successful return to family and community. Keywords: Addiction, Maternal experience, Metasynthesis, Wome

Relationship among employees' emotional intelligence, rganizational performance and organizational culture at Shahid Beheshti University of Medical Sciences

Abstract --------------------------------------------------------------------------------------------------------------------------------Background and Objectives: Employees' emotional intelligence and a strong organizational culture,contributes to selecting appropriate strategies and improvement of organizational performance. The purposeof this study was to investigate the relationship among emotional intelligence, organizational performanceand organizational culture of managers and staff in faculties of Shahid Beheshti University of MedicalSciences.Materials and Methods: This was a correlational research, assessing the relationship among emotionalintelligence, organizational culture and performance. The sample of the study consisted of 200 managers andemployees' serving in faculties of Shahid Beheshti University of Medical Sciences, Tehran, Iran. Participantswere included in the study by stratified sampling method. Data were collected by a questionnaire whichconsisted of four sections: demographic information , emotional intelligence , organizational culture , andorganizational performance. The reliability of the questionnaire was determined by computing Cronbach'salpha. Data wer analysed by Pearson test and SPSS and LISLER software .findings: 76.2 % of the respondents were female , 79.5 % of them aged 25 to 40 years, the educationallevel of 65.5 % of respondents were bachelor, 29% master and 5/5 percent PhD. The scores for emotionalintelligence, organizational performance and organizational culture were (3.51 ±0.348),(4.03±0.494) and(2.99±0.649) respectively. There was a significant correlation between emotional intelligence scores andorganizational culture (r=0.364 P=0.0001) , emotional intelligence and organizational performance ( r= 0.606P=0.0001) and organizational culture and performance( r= 0.363 P= 0.001) .Conclusion: The results indicate that there is a significant correlation among emotional intelligence andorganizational performance and organizational culture in a sample of employees' in faculties of ShahidBeheshti University of Medical Sciences.Keywords: emotional intelligence, enterprise performance, corporate cultur

Basic requirements for implementation of total quality management in Centers of Emergency Medical Services in Iran according EFQM model

Basic requirements for implementation of total quality management in Centers of Emergency Medical Services in Iran according EFQM model Abedsaeedi, Z1. (PhD); Mozafari,M2.*((PhD); Pazargadi,M.3 (PhD);  Alavi majd, H.4 (PhD) 1. Assistant Professor, Dept of Medical Surgical, Faculty of  Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran2. PhD Student, Dept of Nursing, Faculty of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Lecturer, Ilam University of Medical Sciences, Ilam, Iran 3. Associate Professor, Dept. of Management, Faculty of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran4. Associate Professor, Dept. of Biostatistics. Faculty of Paramedicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran AbstractBackground and aimSuccessful implementation of TQM requires a committed leadership, customer – based approaches, process management, efficient communication, knowledge management, empowerment and involvement of staff and an organizational culture for continuous quality improvement. The aim of this study was to assess basic requirements for implementation TQM in Centers of Emergency Medical Services in Iran according EFQM model. Materials and methodsIn this descriptive study, all of operational and official stations of Medical Emergency services  in Ilam, Bushehr, Mazandaran, Ardebil, West Azerbaijan and Yazd province, one half of operational stations in city of Tehran, Sistan–Baluchestan, Khorasan-razavi and Isfahan, were included. All senior managers  and personnel of these centers  and a random sample   of 3246 customers who have  received  care during the last 6 months were selected. By using a 189 –item’s rating scale and 4 questionnaires; leadership style, job and patients satisfaction and state of organizational empowering, according to 5 enabler criteria, from  EFQM  model was assessed. Validity of instruments by measuring content validity and reliability by internal consistency and test-retest confirmed. Descriptive and inferential statistics used for analyzing data. Findings The overall mean score was 168.4±34.6 out of 500; therefore, the selected divisions were labeled as drifters organizations which were in early stage of quality improvement road. In comparison, the Tehran, Isfahan and Khorasan-razavi centers with more score labeled as improver’s organizations. At the entire, leadership criterion obtained minimum (26.6%) and people criterion obtained maximum (39%) mean scores. ConclusionResults showed that enabler criteria of the EMS centers in Iran need to reinforcement. It is essential enhancing the knowledge and attitude of managers and personnel about quality improvement principles. Additionally, establishing the management by process, creating customer focused approach and culture of continuous improvement, empowering employees and constituting quality circles are appropriate interventions that should be considered Keywords: European Foundation for Quality Management (EFQM), Total Quality Management (TQM), Center for Management of Accidents and Emergencies, Emergency System, Enabler criteria. *Corresponding Author: Mosayeb, Mozafari. Dept of Nursing. Faculty of Nursing & Midwifery, Ilam University of Medical Sciences, Ilam, Iran, Banganjab. E-mail: [email protected] 

Icu nurses attitude to evidence based practice in Ardebil University of Medical Science’s hospitalsin1391

AbstractBackground and aim:  The evidence-based practice is the main objective of policy, management and training of health care in developed countries and significant investment has been done to develop it. Cause of high quality care providing importance in the ICU, it is necessary to familiarize nurses with the evidence in care. Awareness of nurse’s attitude allows changing and improving their approach. This study aimed to determine attitudes of nurses working in educational medical science hospitals ICUs in Ardabil city.Materials and methods:  In this descriptive study, 234 ICU nurses have selected with census method. To measure the attitude,questionnaire form that its validity was determined by content validity and its reliability was determined by using Cronbach’s alpha(α = 0. 78) have used. Data analysis was performed with the software spss18.Results: Most nurseshad positive attitudes toevidence-basedcaresandevidencevalidityand its useinclinicalcareandnegativeattitudestotheimportanceofcilinicalexperience. There is a significant relation between level of education, clinical experience, training and management, survey quantity, access to result of research, with mean of attitude score. Conclusions:  Despite positive attitudes to evidence-based practice and its clinical use, access to research evidence and use is low.Keywords: Evidence based practice, Attitud, ICU, Nurse REFERENCES Aghahoseini SH (2011) [Nurses ‘knowledge and attitude in evidence-based nursing in kashan university of medical sciences’ teaching hospitals]. Tabriz Nursing & Midwifery Journal . 6(2) 45-54 (Persian) Beyea SC ,Slattery M j(2006) Evidence-based Practice in Nursing: A Guide to Successful Implementation    Hcpro, Inc.Breimaier H E , Halfens RJG M, Lohrmann C (2010) Nurses’ wishes, knowledge, attitudes and perceivedbarriers on implementing research findings into practice among graduate nurses in Austria. Journal of Clinical Nursing. 20(11-12)1744-56Brown CE , Kim sc, Stichler JF,Fields W (2010) Predictors of knowledge, attitudes,use and future use of evidence- based practice among baccalaureate nursing students at two universities.  Nurse Education Today. 30(6) 521-527Bucknal TK (2003) The clinical landscape of critical care: nurses , decision – making Journal of Advanced Nursing. 43(3)310-319 Camiah S (1997) Utilization of nursing research in practice and application strategies to raise research awerness among nurse practitioner: a model for success. Journal of Advanced Nursing. 26(1)193-202 Courtney M (2005) Evidence for Nursing Practice. Elsevier Australia. Cullum N, Ciliska D,Haynes B, Marks S(2010) [Evidence-Based Nursing: An Introduction]. Translated by: SedaqatiM,Hamedi S. 1rst Edition. Tehran. Salemi Publisher. (Persian). Egerod I, Hansen G M. (2004) Evidence-based practice among Danish cardiac nurses: a national survey. Journal of Advanced Nursing. 51(5) 465–473 Estrabrooks C. A (1998) Will evidence based practice make practice perfect? Canadian Journal of Nursing Research. 30(1) 15-36 HabibiSh, RezaeiHachesoo P, Tabaghi R (2010) [ Enhancing information literacy as a base of developing evidence-based nursing]. Health Information Management. 7(3) 371-378)Persian) Hockenbery M, Wilson D, Barrera P (2006) Implementing evidence based nursing practice in a pediatric hospital. Pediatric Nursing. 32(4)371-377 JalaliniaF. The consequences of qualitative and quantitative evidence-based education in nursing students: a study of the combination. The Ph. D. thesis in nursing. Baqiyatallah university of medical sciences. (2011))Persian) KermanshahiS , Parvinian A M (2012) [Barriers to implementation of evidence-based care: Viewpoints of nursing staff]. Iranian Journal of Medical Education. 12(2): 84-92)Persian) Killen M B, Barnfather J S (2005) A successful teaching strategy for applying evidence based practice. Nurse Educator. 30(3) 127-132  Koessl B D. (2009). Factors Influencing Rural Nurses Attitudes and Beliefs Toward Evidence Based Practice,. A thesis submitted in partial fulfillment of the requirements for the degree of Master of Nursing. Montana State University.Koehn M , Lehman K (2008) Nurses perceptions of evidence based nursing practice. Journal of Advanced Nursing. 62(2) 215-209 Koivunen M, Valimaki M ,Hatonenn H (2010) Nurses’ information retrieval skills in psychiatric hospitals–   Are the requirements for evidence – based practice fulfilled ? Nurse Education in Practice. 10(1)27-31 Kothari A, Birch S, Charles C (2005) “Interaction” and research utilization in health policies and programs: Does it work? Health Policy. 71(1) 117–125Krugman M (2003) Evidence – based practice: The role of staff development. Journal for Nurses in Staff Development. 19(6) 279-285Lai NM , Teng CL, lee ML (2010) The place and barriers of evidence based practice: knowledge and perceptions of medical , nursing and allied health practitioners in malaysia. BMC Research Notes. 3: 279MehrdadN , Salsali M, Kazemnejad A (2007) [Nurses’ attitudes toward research utilization in clinical practice]. Hayat. 13(2): 41-52)Persian)NezamzadehM,Nouri J Khademolhosseini SM(2011)[ Quality of nursing evidence based guidelines from the nurses view]. Iranian Journal of Critical care Nursing. 4(1)53-58)Persian)O’Donnell CA(2004) Attitudes and knowledge of primary care professionals towards evidence-based practice:a postal survey. Journal of Evaluating Clinical Practice. 10(3) 197-205.Polit D F, Beck C T (2008) Nursing Research: Generating and Assessing Evidence for Nursing Practice. 8nd Edition. Lippincott Williams and Wilkins.Rodgers S (1994) An exploratory study of research utilization by nurses in general medical and surgical wards. Journal of Advanced Nursing. 20(4) 904-911Rycroft – Malone J et al (2004) An exploration of the factors that influence the implementation of evidence in to practice. Journal of Clinical Nursing 13(8) 913-924Smith R (1996) What cilinical information do doctors need? British Medical Journal. 313(7064) 1068-1062 Soltani A (2007)[Evidence Based Medicine]. 1rst Edition. Tehran. Tehran university publisher. )Persian)  Tahmasebifard N, Nakhshab M, Shafiei M (2012)[A primary study on the attitude, knowledge and behavior of speech and language pathologists toward evidence-based practice]. Journal of Research In Rehabilitation Sciences. 8(1) 65-76)Persian)Wallin L , Bostrom AM , Wikblad K , Edwald U (2003) Sustainability in changing clinical practice promotes evidence-based nursing care. Journal of Advanced Nursing. 41(5) 509-518  

Physical Health Status in Multiple Sclerosis Patients in Tehran City

AbstractBackground and aimSymptoms of Multiple Sclerosis (MS) are unpredictable; they vary from person to person, and fromtime to time in the same individual. Research conducted in Iran, didn't focus specifically onthe health status of MS. Therefore, we undertook this study on physical health status in MS patients.Materials and MethodsThis is a descriptive cross-sectional study on 119 MS patients, recruited through conveniencesampling. Data were collected using the physical section of the "Multiple Sclerosis Quality of LifeInventory (MSQLI)", with 78 items and 0.93 Cronbach's coefficient that translated to Persian andadapted to Iranian culture by researchers.FindingsThe physical health status was moderate in 49.6%. The lowest mean score percent was for physicalcomponent 41.06(12.9) and the highest mean score percent was for Impact of visual impairment87.05(16.1). Physical components indicated a significant positive correlation with fatigue impact,pain effect and bladder control. We found a significant positive correlation between fatigue impactwith pain effects, sexual satisfaction, and bladder and bowel control. Moreover, significant positivecorrelations were found between pain effects with sexual satisfaction and bowel control; sexualsatisfaction and bladder and bowel control; bladder control and bowel control.ConclusionThese findings may assist health care providers to identify patients at risk of aggravating physicalhealth status; thus allowing appropriate and timely interventions to be conducted.Keywords: Multiple sclerosis, Physical health, Fatigue, Pain, Bladder Control, Bowel Control,Sexual Dysfunction, Visual Dysfunction.*Corresponding author: Tahereh Ashktorab, Assistant Professor, School of Nursing & Midwifery,Shahid Beheshti University of Medical SciencesE-mail: [email protected] N Sadat S Abazari P (2006). [The experiences of patients with multiple sclerosis]. Iranian Journal ofNursing & Midwifery Research. 11(2).[Online].<http://nm.mui.ac.ir/journal/main.php?filename=article.php&nomagazine=31&noart=1&fo oter=footer1.php>.(Persian).-Benito-Leon J et al (2003). A review about the impact of multiple sclerosis on health-related quality of life. Disabilityand Rehabilitation. 25(12) 1291–1303.-Casetta I et al (2009) Gender differences in health-related quality of life in multiple sclerosis. Multiple Sclerosis. 15(11) 1339–1346.-Dennison L Moss-Morris R and Chalder T (2009). A review of psychological correlates of adjustment in patients withmultiple sclerosis. Clinical Psychology Review. 29 (2) 141-153.-Douglas C Wollin J Windsor C (2008). Illness and demographic correlates of chronic Pain among a community-basedsample of people with multiple sclerosis. Archives of Physical Medicine and Rehabilitation. 89 (10) 1923-1932.-Fischer J et al (1999) Recent developments in the assessment of quality of life in multiple sclerosis (MS). MultipleSclerosis. 5 (4) 51-259.-Füvesi J et al (2010). Factors influencing the health-related quality of life in Hungarian multiple sclerosis patients.Journal of the Neurological Sciences. 293 (1-2) 59–64.-Flensner G et al (2008). Fatigue in relation to perceived health: people with multiple sclerosis compared with people inthe general population. Scandinavian Journal of Caring Science. 22 (3) 91-400.-Forbes A et al (2006). Health problems and health-related quality of life in people with multiple sclerosis. ClinicalRehabilitation. 20 (1) 67-78.-Fruehwald S et al (2001). Depression and quality of life in multiple sclerosis. Acta Neurologica Scandinanvia. 104 (5)257-61.-Ghaem H Borhani Haghighi A (2008). The impact of disability, fatigue and sleep quality on the quality of life inmultiple sclerosis. The Annals of Indian Academy of Neurology. 11(4) 36–241.-Higginson IJ et al (2006). Symptom prevalence and severity in people severely affected by multiple sclerosis. Journalof Palliative Care. 22 (3) 58-65.-“Just the Facts” National Multiple Sclerosis Society, 21 Dec 2008 [Online]. <http://www.nationalmssociety.org/aboutmultiple-sclerosis/what-is-ms/index.aspx>. [20 March 2009].-Masoodi R et al (2008). [The effect of Orem based self-care program on physical quality of life in multiple sclerosispatients]. Journal of Shahrekord University of Medical Sciences. 10 (2) 21-30. (Persian).-Multiple Sclerosis Association of Iran (2010). [Activities Report of Multiple Sclerosis Association of Iran in 2009].(Persian).-Patti F et al (2003). Health related quality of life and depression in an Italian Sample of Multiple sclerosis patients.Journal of the Neurological Sciences. 211 (1–2) 55–62.-Paul GM et al “Multiple Sclerosis Quality of Life Inventory: A User's Manual”. New York: National Multiple SclerosisSociety, 1997 [Online].<http://walkcoc.nationalmssociety.org/docs/HOM/MSQLI-Manual-and-Forms.pdf>.[10 April2009].-“Process of translation and adaptation of instruments”. World Health Organization, 2009. [On line]. [cited 2 August2009].< http://www.who.int>.>.[10 September 2009].-Shahbeigi S (2010). 7th International Congress of Multiple Sclerosis Tehran, Iran. Medical News. 1. (Persian).-Smeltzer S Bare B Hinkle J and Cheever K (2008). Brunner and Suddarth’s Textbook of Medical Surgical Nursing.11th edition. Volume 2. Philadelphia, Lippincott.-Tepavcevi1 D Pekmezovi1 T Drulovi1 J (2009). Quality of life assessment in patients with multiple sclerosis.Vojnosanit Pregl. 66 (8) 645-50.-Turpin K et al (2007). Deterioration in the health-related quality of life of persons with multiple sclerosis: the possiblewarning signs. Multiple Sclerosis. 13 (8) 1038–1045.-Vanner EA et al (2008). Pilot Study Exploring Quality of Life and Barriers to Leisure-time Physical Activity in Personswith Moderate to Severe Multiple Sclerosis. Disability and Health Journal. 1 (1) 58-65.-Vazirinejad R Lilley J Ward C (2008). A health profile of adults with multiple sclerosis living in the community.Multiple Sclerosis. 14 (8) 099–1105.-Visschedijk M et al (2004). Value of Health-related Quality of Life to Predict Disability Course in Multiple Sclerosis.Neurology. 63 (11) 2046-50.-“What is Multiple Sclerosis?” Multiple Sclerosis Association of America, 2008. [Online].<http://www.msassociation.org/about_multiple_sclerosis/whatisms>. [22 March 200

Marital satisfaction and therapeutic regimen compliance in hemodialysis patients in hospitals of Shahid Beheshti University of Medical Sciences and Health Services in 1388- 89.

AbstractBackgrounds and aimTherapeutic regimen non compliance is a common problem in hemodialysis patients. It is associated withmany side effects. Marital satisfaction and conflictions in dyadic relationships have an important effect oncompliance of a complex regimen. This study aims to determine the correlation between marital satisfactionand therapeutic regimen compliance in hemodialysis patients in hospitals of Shahid Beheshti University ofMedical Sciences and Health Services in 1388-89.Materials and MethodsIn this descriptive correlatiional study 100 hemodialysis patients were selected through the judgmentalsampling method. Data gathering tool was a questionnaire consisting three parts: demographic data, diseaseand ENRICH Marital Satisfaction Inventory. The latter part is validated by content validity method. Thereliability of ENRICH Marital Satisfaction Inventory was determined by Chronbach’s = method. Thequestionnaires were completed by patients during hemodialysis. In order to determine the compliance oftherapeutic regimen, the researcher recorded the mean of the last three months’ values of P, K, interdialyticweight gain, and the numbers of missed dialysis sessions using patient’s documents. Data were analyzed bySPSS statistical softwareFindingsWhile 56% of patients had compliance in therapeutic regimen. 59% had low and very low and 41 % ofpatients had moderate and high marital satisfaction. There was a significant correlation between maritalsatisfaction and therapeutic regimen compliance and marital satisfaction in patients with therapeutic regimencompliance was high.ConclusionPlanning for counseling and supportive programs concerning marital satisfaction can be beneficial for patientsand their families in order to increase their therapeutic regimen compliance.Keywords: Marital satisfaction, Compliance, Hemodialysis, Chronic renal failur

Physiologic indices of patients before, during and after visit in coronary care unit at Imam Khomeini hospital in Ardebil

Physiologic indices of patients before, during and after visit in       coronary care unit at Imam Khomeini hospital in Ardebil                                                                                                                                                    Kamrani, F.1* (MSN); Seyedjavadi, M.2 (MSN); Abedsaeedi, Zh.3 (PhD); Ezzati, Zh.4  (MSN); Alavimajd, H.5  (PhD);  Hosseinian, A.6 (MD) 1. Lecturer, Dept. of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti    University of Medical Sciences, Tehran, Iran. 2. Alumnus, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Science,    Tehran, Iran3. Assistant Professor, Dept. of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Shahid    Beheshti University of Medical Science, Tehran, Iran.4. Lecture, Dept. of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti    University of Medical Sciences, Tehran, Iran.5. Associate Professor, Dept. of Biostatistics, Faculty of Paramedical, Shahid Beheshti University of    Medical Sciences, Tehran, Iran.6. Cardiologist, Faculty of Medicine, Ardebil University of Medical Sciences, Ardebil, Iran. Abstract Background and aimVisit is an essential issue in hospitals and of patients' basic needs in coronary care units (CCUs). However, there is no evidence regarding its physiologic effects on  them. The aim of this was to determine the physiologic indexes of patients before, during and after visit at CCU of Imam Khomeini Hospital in Ardebil. Materials and methodsIn this descriptive study, 50 patients with acute myocardial infarction were selected through convenience sampling method. A questionnaire and a cardiac monitoring device were used for data collection. Content method and calibration the device were used for validity and reliability of the tools respectively. ANOVA with repeated measurements was used for data analysis. Findings %72 of patients was male and %28 was female. Their mean age was 59.8. Significant differences were found between systolic, diastolic and mean arterial pressures; heart as well as respiratory rates; temperature; and oxygen saturation before, during and after the visits. Accordingly, the indexes increased significantly by the start of visits and turned back to the previous state after them with no significant difference in before-after amounts. ConclusionIt seems that the physiologic indices of patients change in normal range during visits and return to their primary state after 30 minutes from the end of visits with no clinical importance. Keywords: Visit, Coronary Care Unit (CCU), Physiologic indexes. *Corresponding Author: Lecturer, Dept. of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. E-mail: [email protected]