Nurses’ perceptions of evidence-based practice: a quantitative study at a teaching hospital in Iran

Background: Evidence-based practice (EBP) provides nurses a method to use critically appraised and scientifically proven evidence for delivering quality health care and the best decision that leads to quality outcomes. The purpose of this study was to measure the practice, attitude and knowledge/skill of evidence-based practice of nurses in a teaching hospital in Iran. Methods: This cross-sectional study was conducted in 2011.The study sample was composed of 195 nurses who were working at the Fatemeh Zahra Hospital affiliated to Bushehr University of Medical Sciences (BPUMS). The survey instrument was a questionnaire based on Upton and Upton study. This tool measures Nurses' perceptions in the three sub-scales of practice, attitude and knowledge/skill of evidence-based practice. Descriptive statistical analysis was used to analyze the data. Pearson correlation coefficients were used to examine the relationship between subscales. Results: The overall mean score of the evidence-based practice in this study was 4.48±1.26 from 7, and the three subscales of practice, attitude and knowledge/skill in evidence-based practice were, 4.58±1.24, 4.57±1.35 and 4.39±1.20, respectively. There was a strong relationship between knowledge and performance subscale (r=0.73, p< 0.01). Conclusion: Findings of the study indicate that more training and education are required for evidence-based nursing. Successful implementation of evidence-based nursing depends on organizational plans and empowerment programs in hospitals. Hence, hospital managers should formulate a comprehensive strategy for improving EBP

Role of Organizational Climate in Job Involvement: A Way to Develop the Organizational Commitment of Nursing Staff

Employees are the most valuable assets of an organization; therefore, it is very important to understand their behavior. In this regard, the present study was carried out in order to examine the effect of organizational climate on job involvement among nurses working in the teaching hospitals of Qazvin Province, Iran. The present descriptive analytical study was done in 2017. To randomly select a specific proportion of nurses from each of Qazvin teaching hospitals, stratified sampling was used. In total, 340 nurses were selected. Data were collected using 3 questionnaires: Halpin and Kraft Organizational Climate Questionnaire, Job Involvement Questionnaire (Kanungo), and Allen and Myer Organizational Commitment Questionnaire. For data analysis, confirmatory factor analysis and structural equation modeling were used applying AMOS-24 software. The results of path analysis showed the effect of organizational climate on the nurses' job involvement. Moreover, organizational climate influenced organizational commitment through the mediation of job involvement. According to values obtained for degree of freedom based on chi-square, goodness-of-fit index, root mean square error of approximation, and comparative fit index were in the defined range; therefore, the validity of the conceptual model was approved. Based on the results of the present study, managers of health organizations can achieve their goals by understanding the organizational climate of the hospitals and its effect on the employees' job involvement and discovering strategies needed for organizational commitment improvement

OBRAS DEL MUSEO [Material gráfico]

Copia digital. Madrid : Ministerio de Educación, Cultura y Deporte, 201

The effect of educational intervention on medication adherence behavior in patients with type 2 diabetes: application of social marketing model

Background: Patient’s adherence to the medication regimen leads to successful treatment in diabetic patients and a reduction in the severity of complications. Educational intervention is needed to improve behavior and change attitudes in diabetic patients. The aim of this study was to determine the effect of educational intervention based on social marketing on promoting medication adherence behavior in type 2 diabetic patients. Materials and methods: Using random sampling, 110 diabetic patients covered by health centers in Qazvin in the form of experimental and control groups participated in a randomized controlled trial. Data collection tools included demographic questions and valid scales related to psychological constructs and drug adherence. The intervention program consisted of 5 group training sessions for 90-60 minutes based on the initial needs assessment and the theoretical framework of the social marketing model for the experimental group. Also, a purposeful educational pamphlet, two sessions of telephone counseling, and educational messages via mobile phone were provided in addition to the group training program for patients in the experimental group. Data were analyzed using SPSS software version 25 and independent sample t-test, Chi-square test, One-way ANOVA, and covariance analysis. Results: The mean age of study participants was (54.12 ± 8.22) years. Also, the average duration of diabetes was 5-10 years and 50% had primary education. The correlation between attitude, self-efficacy, and subjective norm with medication adherence behavior was significant (p &lt;0.05). After the intervention based on the social marketing model, the mean of the constructs of attitude (39), self-efficacy (31), awareness (66), subjective norm (85), and medication adherence (49) increased significantly in the experimental group. Conclusion: Educational intervention based on social marketing could have a significant effect on improving medication adherence behavior. The design of cognitive-behavioral interventions based on social marketing is recommended to promote the health behaviors of diabetic patients

Application of Balanced Scorecard (BSC) in Evaluating the Performance of Health Care Providers: A Review

Background: As a comprehensive approach to assessing the performance of hospitals, Balanced Scorecard methodology is a tool to transform the organization's mission into concrete measurable objectives, activities and performance. Methodology: The present study is a systematic review conducted via searching in different sites, such as: Magiran, Irandoc, Google Scholar, Iranmedex. Several studies on the balanced scorecard have been done in different organization. In this study, we chose the articles aiming to assess the health care and hospital using BSC. Then their subjects were compared with the present study, and then the related studies were briefly mentioned. Finding: Based on the results of studies in this area, the main purpose of using the balanced scorecard can be used in studies such as the ability to update the strategy, the establishment of the strategy throughout the organization, coordination unit and individual goals of the strategy, linking strategic objectives to long-term goals and annual budget through performance measures, assessment of performance for learning and improvement strategies. Results: The results of this study showed that combining models is a way for assessing function and increasing the satisfaction and commitment. And the balanced scorecard is recommended as a model that can help increase efficiency and better evaluation of the performance

Comparing the pharmacology knowledge and performance of nurses and nursing students in the use of information resources in pediatrics wards: An observational study

Objectives: One of the major duties of nurses is proper medication administration while maintaining patient safety, which requires sufficient knowledge and practice. Any gaps in knowledge used by nurses can lead to irreversible injury or death of the patient. This study is aimed to determine and compare the pharmacology knowledge and performance of nurses and nursing students in using the information resources in pediatrics wards. Method: This descriptive observational study was performed on 300 nurses and nursing students. Sources of knowledge and performance of nurses and nursing students were analyzed with researcher-made tools to determine their pharmaceutical knowledge, sources of knowledge, and attitudes by independent t-test, chi-square, one-way analysis of variance, Pearson, and Spearman tests. Result: Three hundred questionnaires were examined. The clinical experience of nurses and students was their most important source of information in drug challenges for 33.7% of the participants. About 24.6% of nurses obtained the required information from specialized books on pediatric medicine. About 17.1% of the participants attained their knowledge from multiple sources (e.g. various available sources such as the Internet, pharmacy books, software, and their experiences and colleagues), while electronic sources and the Internet were the sources of knowledge for 15.5% and 7.7% of the nurses, respectively. Concerning nursing students, 6.3% used books, 41.7% considered colleagues (clinical experiences), 20.8% employed electronic resources, 22.8% used the Internet, and 9.1% relied on multiple sources. There were significant differences in the knowledge and performance of the nurses based on their source of pharmacological knowledge (P < 0.05). Conclusion: Most of the resources used in the hospital are not up-to-date and evidence-base, and the majority of nurses tend to rely on their clinical experience or their collegues information for medication administration rather than reading books or searching for up-to-date approaches and information. Nursing students also trust nurses’ clinical experiences more than other sources provided for them including books and Internet. Some action should be taken by the managers for boosting the nurses’ tendency for using up-to-date information resources

The effects of the health reform plan on the performance indicators of hospitals affiliated with Qazvin University of Medical Sciences, Iran, 2014

BACKGROUND: One of the significant goals of healthcare delivery organizations is to promote people’s health and provide high quality care. In this regard, health reform plan was designed in Iran. Therefore, the present study aimed to evaluate the performance of teaching hospitals after running of health system reform plan in Iran.METHODS: This retrospective-descriptive study was carried out in 4 hospitals (Avicenna, Velayat, Rajaee, and Qhods) affiliated with Qazvin University of Medical Sciences, Qazvin, Iran, in 2014. Data collection tool was the checklist of standard indicators of Iranian Ministry of Health, because the checklist is standard to measure hospitals’ performance. In this study, 19 indicators (performance indicators, personnel indicators, and financial indicators) were investigated. To fill out the indicators checklist, the statistics unit of Ministry of Health was used according to the reports of two consecutive years of 2013 and 2014. The collected data were analyzed using Excel software.RESULTS: In general, out of the 7 performance indicators that were investigated in the hospitals, increase was observed in four, and decrease was seen in three items. Out of the six personnel indicators, all of the hospitals experienced a rise; and out of the six financial indicators, four items increased and two decreased.CONCLUSION: The results of this study indicated that after one year of implementing health reform plan, the mentioned health care system experienced a remarkable progress in the hospitals. Providing the necessary infrastructures can help better conduction of the plan and promotion of the mentioned indicators by removing or decreasing the effect of some barriers

Nurses’ understanding of evidence-based practice: Identification of barriers to utilization of research in teaching hospitals

BACKGROUND: In medical organizations, utilizing evidence-based practice (EBP) helps nurses and patients make the best decision in health care in certain clinical settings. Hence, recognizing its educational barriers is so important.METHODS: The present study was a descriptive-analytical research that was conducted using a cross-sectional design in 6 teaching hospitals of Qazvin City, Iran, in 2014. The study sample consisted of 260 nurses. Based on the number of the nurses working in each hospital, the study sample was chosen by a stratified random method. Two questionnaires were employed to collect the required data. The first questionnaire was Evidence-Based Practice Questionnaire (EBPQ) that evaluates nurses’ understanding of EBP. The second questionnaire was related to measuring the barriers to utilization of research by the nurses that was developed by Funk et al. For analyzing the collected data, frequency distribution tables, analysis of variance (ANOVA), and linear regression coefficient were used.RESULTS: The total mean of EBP among the nurses was at a level above average. The subscales of knowledge/skill (3.74) and attitude (3.87) had a lower average compared to the subscale of practice (4.14). The total mean of the barriers was 3.07. According to the results of the present study, organization and adopter had the highest and lowest means, respectively.CONCLUSION: Identifying the barriers that affect effective EBP implementation can help nurses achieve their goals by removing these obstacles, building the necessary infrastructure, and providing human, physical, and financial resources