Development and psychometric evaluation of the patient safety violation scale in medical oncology units in Iran

Background: Patient safety is one of the key components of nursing care for cancer cases. Valid and reliable context-based instruments are necessary for accurate evaluation of patient safety in oncology units. The aim of the present study was to develop and evaluate the psychometric properties of the Patient Safety Violation Scale in medical oncology units in Iran. Materials and Methods: In this methodological study, a pool of 58 items was generated through reviewing the existing literature. The validity of the 58-item scale was assessed through calculating impact score, content validity ratio, and content validity index for its items as well as conducting exploratory factor analysis. The reliability of the scale was evaluated by assessing its internal consistency and testretest stability. Study sample consisted of 300 oncology nurses who were recruited from thirteen teaching hospitals affiliated to Tehran University of Medical Sciences, Tehran, Iran. Results: Sixteen items were excluded from the scale due to having low impact scores, content validity ratios, or content validity indices. In exploratory factor analysis, the remaining 42 items were loaded on five factors including patient fall, verification of patientidentity, harm during care delivery, delay in care delivery, and medication errors. These five factors explained 62 of the total variance. The Cronbach's alpha of the scale and the test-retest interclass correlation coefficient were equal to 0.933 and 0.92, respectively. Conclusions: The 42-item Patient Safety Violation Scale is a simple and short scale which has acceptable validity and reliability. Consequently, it can be used for assessing patient safety in clinical settings such as medical oncology units and for research projects

Support in Clinical Settings as Perceived by Nursing Students in Iran: A Qualitative Study

Background: Although support is one of the most substantial needs of nursing students during clinical education, it is not clearly defined in the literature. Objectives: The current study aimed to explore the concept of support in clinical settings as perceived by nursing students. Materials and Methods: A qualitative content analysis was used to explore the meaning of student support in clinical settings. A purposive sampling with maximum variation was used to select the participants among bachelor nursing students in the nursing school of Babol University of Medical Sciences in the north of Iran. Semi-structured interviews were conducted to gather the perceptions and experiences of seventeen nursing students. Conventional content analysis was applied to analyze the data. Results: In the current study, the main theme, nurturance, was emerged with seven subthemes of humanistic behavior with the student, respectful communication with students, accepting the student in the clinical setting, sustaining confidence, need based supervision, accepting the profession in the society and empowerment. Conclusions: Nursing students support in the clinical education requires a nurturing care; a care that leads to the sense of worthiness and respectability in students and contributes to the improvement of their clinical abilities

Factors affecting ethical behavior in pediatric occupational therapy: A qualitative study

Background: It is the responsibility of each occupational therapist to always act ethically and professionally in a clinical setting. However, there is little information available concerning the factors influencing ethical behavior of occupational therapists at work. Since no study has been conducted in Iran on this topic, this qualitative study aimed to identify the factors influencing ethical behavior of pediatric occupational therapists. Methods: Twelve pediatric occupational therapists participated in this study. The sampling was purposeful, and the interviews continued until reaching data saturation. All interviews were recorded and transcribed. The data were analyzed by qualitative content analysis, and the ethics of qualitative research was considered. Results: The factors influencing ethical behavior were classified into four main categories including organizational factors, therapist related factors, client's family issues, and social factors. Conclusion: This study identified numerous factors influencing the ethical behavior of pediatric occupational therapists that could be used to train occupational therapists, human resources managers, professional policy makers, and could also be used to conduct future researches, and produce tools

Moral neutralization: Nurses� evolution in unethical climate workplaces

Introduction: Good quality of care is dependent on nurses� strong clinical skills and moral competencies, as well. While most nurses work with high moral standards, the moral performance of some nurses in some organizations shows a deterioration in their moral sensitivity and actions. The study reported in this paper aimed to explore the experiences of nurses regarding negative changes in their moral practice. Materials and methods: This was a qualitative study utilizing an inductive thematic analysis approach, which was conducted from February 2017 to September 2019. Twenty-five nurses participated in semi-structured interviews. Results: The main theme that emerged from our analysis was one of moral neutralization in the context of an unethical moral climate. We found five sub-themes, including: (1) feeling discouraged; (2) normalization; (3) giving up; (4) becoming a justifier; and (5) moral indifference. Conclusions: Unethical moral climates in health organizations can result in deterioration of morality in nurses which can harm both patients and health systems. Some unethical behaviors in nurses can be explained by this process. © 2020, The Author(s)

Medication errors in the Middle East countries: a systematic review of the literature

Background: Medication errors are a significant global concern and can cause serious medical consequences for patients. Little is known about medication errors in Middle Eastern countries. The objectives of this systematic review were to review studies of the incidence and types of medication errors in Middle Eastern countries and to identify the main contributory factors involved. Methods: A systematic review of the literature related to medication errors in Middle Eastern countries was conducted in October 2011 using the following databases: Embase, Medline, Pubmed, the British Nursing Index and the Cumulative Index to Nursing & Allied Health Literature. The search strategy included all ages and languages. Inclusion criteria were that the studies assessed or discussed the incidence of medication errors and contributory factors to medication errors during the medication treatment process in adults or in children. Results: Forty-five studies from 10 of the 15 Middle Eastern countries met the inclusion criteria. Nine (20%) studies focused on medication errors in paediatric patients. Twenty-one focused on prescribing errors, 11 measured administration errors, 12 were interventional studies and one assessed transcribing errors. Dispensing and documentation errors were inadequately evaluated. Error rates varied from 7.1% to 90.5% for prescribing and from 9.4% to 80% for administration. The most common types of prescribing errors reported were incorrect dose (with an incidence rate from 0.15% to 34.8% of prescriptions), wrong frequency and wrong strength. Computerised physician rder entry and clinical pharmacist input were the main interventions evaluated. Poor knowledge of medicines was identified as a contributory factor for errors by both doctors (prescribers) and nurses (when administering drugs). Most studies did not assess the clinical severity of the medication errors. Conclusion: Studies related to medication errors in the Middle Eastern countries were relatively few in number and of poor quality. Educational programmes on drug therapy for doctors and nurses are urgently needed

Explanation of parent gender difference on needs of children of parent with mental illness: a qualitative research

Background: Parents play an important role in a child's life. The roles of parents are impaired by mental illness and this issue affects the child’s needs and meets them. Objective: This study was designed and conducted to explain gender differences of parents with mental illness on their children needs. Methods: This study was conducted using the grounded theory. Semi structured interviews were conducted with 17 participants in Qazvin 2010, selected based on purposeful and theoretical sampling. Participants included children of patients with mental disorders, their families and mental health professionals (nurses, clinical psychologist and counselor). Data were analyzed using constant comparison method suggested by Strauss & Corbin 1998. Findings: Economic and social outcomes are two major problems occur in father illness, But focus of outcomes of mother's illness is emotional. Although all participants believed except Parents gender, their illness affected on children; but mother illness has serious outcomes. Conclusion: With respect to children problems in parents' mental illness, a special place for children should be considered in the patient care plan, especially when the mother has mental illness that this issue is more important

Iranian nursing students' preparedness for clinical training: A qualitative study

Background: Clinical training plays a fundamental role in nursing students' acquisition of professional capabilities. Students' preparedness for learning in clinical setting is one of the most important factors that determine the quality of clinical training. Different studies indicate the nursing students' unpreparedness for entering clinical environment. Aim: The aim of this study was to explore Iranian nursing students' preparedness for clinical training. Method: This research is a qualitative research using content analysis approach. The participants consisted of seventeen nursing students, three nursing educators and one nurse, selected through the purposive sampling method and questioned in semi-structured interviews. The acquired data was analyzed by qualitative content analysis approach. Results: Two main themes were captured in this study; including: 1) rejection of the profession and 2) fear and anxiety. Conclusion: The findings indicated that the nursing students are not psychologically prepared for internship in clinical settings. Therefore we recommend in the first place reducing students' fear and anxiety of facing the reality and preparing them for a better beginning through conducting workshops in retraining and practicing clinical skills along with a course of visiting the hospital for students' confrontation and familiarization with real environment immediately before entering into the clinical setting. In addition, after the students' entrance to the setting the clinical educators should strive to heed students' level of preparedness especially their psychological needs and condition including the extent to which they accept their profession. © 2015 Elsevier Ltd