Adherence to facility management and safety standards in Shiraz hospitals, Iran

Abstract   Background: Evaluate the adherence to facility management and safety standards among governmental and non-governmental hospitals in Shiraz, Iran.  Methods: In this cross sectional study, 22 hospitals of the 33 hospitals in Shiraz, Iran including 13 governmental and 9 non-governmental facilities were surveyed. A 74-item self-administered questionnaire was used. Collected data were entered to SPSS Version 15.0 software. The level for statistical significance was set at 0.05.  Results: Adherence to facility management and safety standards was 65.17% in governmental and 72.79% in non-governmental hospitals. Compliance by governmental hospital in the areas of leadership and planning, safety and security, emergency management, medical equipment, utility system and staff education ranged from 60% to 86%. However, hazardous materials and fire safety adherence was below 50%. For non-governmental hospitals standard compliance for all areas ranged from 60% to 86%. Compliance rates between governmental and non-governmental hospitals in the areas of hazardous materials and staff education standards were statistically significantly different (p=0.02 and p=0.05 respectively).  Conclusions: To achieve more effective functional health care services, additional studies must be undertaken to assess the nature and extent of problem areas that exist in planning, implementing and monitoring of facility management and safety programs

Evaluation of a Web-based Error Reporting Surveillance System in a Large Iranian Hospital

BACKGROUND: Proper reporting of medical errors helps healthcare providers learn from adverse incidents and improve patient safety. A well-designed and functioning confidential reporting system is an essential component to this process. There are many error reporting methods; however, web-based systems are often preferred because they can provide¬¬¬¬ comprehensive and more easily analyzed information. This study addresses the use of a web-based error reporting system. METHODS: This interventional study involved the application of an in-house designed "voluntary web-based medical error reporting system." The system has been used since July 2014 in Nemazee Hospital, Shiraz University of Medical Sciences. The rate and severity of errors reported during the year prior and a year after system launch were compared. RESULTS: The slope of the error report trend line was steep during the first 12 months (B = 105.727, P = 0.00). However, it slowed following launch of the web-based reporting system and was no longer statistically significant (B = 15.27, P = 0.81) by the end of the second year. Most recorded errors were no-harm laboratory types and were due to inattention. Usually, they were reported by nurses and other permanent employees. Most reported errors occurred during morning shifts. DISCUSSION: Using a standardized web-based error reporting system can be beneficial. This study reports on the performance of an in-house designed reporting system, which appeared to properly detect and analyze medical errors. The system also generated follow-up reports in a timely and accurate manner. Detection of near-miss errors could play a significant role in identifying areas of system defects

Factors Affecting Resistance to Change among Hospital Staff using a Structural Equation Modeling Technique

Introduction: Hospitals are complex organizations faced with continuous fundamental changes complicated by expertise diversity. The aim of this study was to investigate the factors influencing hospital employees’ resistance to change. Methods: This cross-sectional study included 510 employees working in hospitals affiliated to Shiraz University of Medical Sciences; they were selected using stratified random sampling. Data were collected through a questionnaire. A structural equation modeling technique using LISREL Version 8.8 tested the hypotheses and conceptual model. Results: Results indicated that dispositional resistance to change and involvement with change directly affected the employees’ resistance to change. Perceived benefits of change to involvement in change were significant (T-values >1.96) and the hypotheses related to these paths were accepted. Perceived benefits of change indirectly affected the employees’ resistance to change by influencing involvement. Dispositional resistance to change and involvement in change (mediator variables) were estimated 0.89, 0.03, and 0.47, respectively. Conclusion: The study results indicated that hospital managers should encourage the employees to actively participate in their change program by strengthening perception of the benefits. This could help reduce the employees’ resistance

Infection control & management of hazardous materials for the dental team

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Social determinants of health and attempt to change unhealthy lifestyle: A population-based study

Background: A healthy lifestyle is important because of its long-term benefits; however, there is a paucity of information concerning health choices among Iranians. We evaluated personal health behaviors, attempts to change unhealthy behaviors, and factors affecting attempts at change. Methods: The design of this cross-sectional study was to assemble a representative cadre of> 18-year-old adults in Shiraz, Iran, using a multistage cluster sampling technique. Validated questionnaires collected participant's demographic information, such as weight, height, cigarette smoking history, physical activity, and attempts at lifestyle changes during the previous year. To determine predictors of attempts to change unhealthy lifestyle and to identify confounders, we applied single and multivariable logistic regression methods, respectively. A confidence interval of 95% was calculated for each odds ratio. Results: The prevalence of attempts to change unhealthy lifestyle was 42%, 64.8%, and 27.8%, respectively, for losing weight, being more physically active, and smoking cessation. Unemployment, low levels of education, and decreased socioeconomic status have important roles in attempts to change lifestyle conditions. Low socioeconomic status was a risk factor for quitting smoking. Occupation (unemployed/homemaker) and low level of education were two significant factors for being more physically active. Conclusions: The prevalence of inadequate physical activity and being overweight or obese was considerable in Shiraz, Iran. Attempts to change unhealthy lifestyle were less than ideal. Social determinants of health factors including unemployment and low levels of education and socioeconomic status play important roles in attempts to change current lifestyles