Clinical Auditing of Patient Safety Standards Before and After Implementation of the Training Program in Intensive Care Units

AbstractIntroduction: Patient safety is the precious core in the healthcare organizations aimed at minimizing adverse events and eliminating preventable damages. This study aimed at determining the rate of observation of safety standards of ICU patients by nurses before and after implementation of a training program.Methods: This quasi-experimental single-group study was conducted in two phases: observation of nursing performance related to patient safety and the implementation of a corrective training program. In the first phase, 4104 cases of nursing care related to patient safety performed by 54 ICU nurses were observed using chronological sampling. The same samples, i.e., 4104 nursing care performed by the same nurses, were used in the second phase of the study after implementing the training program. The data collection instrument was a valid and reliable researcher-made 76-item questionnaire consisting of 12 categories about nursing care related to patient safety. The corrective training program focused on nursing care related to patient safety. The gleaned data were analyzed with SPSS18 using descriptive statistics and non-parametric Wilcoxon signed-rank tests.Results: The rate of correspondence between nursing care and the checklist was 44.32 % before the intervention, which increased to 95.61% after intervention by a 51.29% increase.Conclusions: Implementation of the corrective intervention effectively promotes patient safety as a training program for nurses. The healthcare system's managers and authorities can reduce the damages sustained by patients and decrease treatment costs by concentrating on periodic supervision and continuous education programs to improve patient safety

Change Management Challenges in Nursing and Midwifery Schools: A qualitative study of managerial experiences

The purpose of this study was to explain the situation and perspectives of managers regarding change in nursing and midwifery faculties. This study was conducted according to a qualitative approach; in fact, a descriptive exploratory approach was applied with triangulation. Snow ball sampling was used in this study. The subjects were faculty members of the nursing schools in Tehran, and the inclusion criteria included at least 1year of experience as a faculty member. In the qualitative phase, no variables were measured. Data were gathered by semi-structured interviews in which a guide and field notes were used. Data were considered to be saturated after observing the repetition of codes. Qualitative conventional content analysis was used for data analysis. Trustworthiness was achieved by prolonged field experience, member check, peer check and sharing the content with two experts in qualitative research. Ten participants (7 females and 3 males) between the ages of 38 and 54 were interviewed. Two of them had Master's degrees, and eight had PhD degrees in nursing; only three of them were in high-level management of their faculties. After the interviews, conceptual codes were extracted, and a few uggested themes were classified, including challenges in change management, such as field of concentration in management, managers' characteristics and attitudes toward change. Accordingly, the concept of change management was postulated as the purpose of this study; furthermore, its influencing factors were identified. The implication of the study is that it may be used in nursing and midwifery faculties as a model for organizational culture. Imposing change in an educational organization without having a proper model of change management will facilitate the achievement of the desired change outcome. Khachian A, Manoochehri H, Pazargadi M, Esmaeili Vardanjani SA. Change Management Challenges in Nursing and Midwifery Schools: A qualitative study of managerial experiences. Life Sci J 2012;9(3);2265-2269] (ISSN: 1097-8135). http://www.lifesciencesite.com. 40

The Lived Experiences of Nurses of Comatose Patients: A Hermeneutic Phenomenology Approach

Introduction: The quality of care in comatose patients is the most significant criteria for evaluation of nursing care quality. This is due to the fact that caring for these patients is long and very burdensome. This criterion is achieved by transferring of experience from experienced nurses to novice nurses. The purpose of this study was to examine the lived experience of caregivers of comatose patients. Method: van Manen’s conception of hermeneutic phenomenology with purposeful sampling of nurses of teaching hospitals was used in Tehran in 2011. The data were collected through 8 interviews. The gathered data were analyzed in order to explain this lived experience. Results: The participants were 5 males and 3 females and were working in critical care units for 6-23 years. 15 essential subthemes were elicited, and were classified into 4 themes. The meaning of caring for comatose patients was explained by the subthemes and themes achieved. Conclusion: The findings of the current study will give nurses a greater knowledge on caring for comatose patients, give greater insight into the issues being faced by the caregiver, lead to a better understanding of the needs of these patients, improve the relationship with the patients, and ultimately help improve the nursing practice. Keywords: Nurses’ lived experiences, Coma, Caring, Hermeneutic phenomenolog

Cancer Stigma and its Consequences and Influencing Factors in Iranian Society: A Qualitative Study

Introduction: Stigma refers to a set of negative attitudes, beliefs, behaviors, and thoughts in dealing with a person who has a chronic disease or some health problems. Cancer is one of the diseases associated with stigma. Stigma causes harmful psycho-social effects for the affected person and family members and is considered an obstacle in disease screening and control programs. Accordingly, this study aimed to explore the nature of cancer stigma and its consequences and influencing factors in Iranian society.Methods: A total of 14 people including cancer patients, their families, and healthcare staff participated in this qualitative study. The participants were selected using purposive sampling and the data were collected through semi-structured interviews. The resulting data were analyzed using conventional content analysis and with MAXQDA software (version 10).Results: The content analysis revealed four themes including cancer as a terrifying and pitiful disease, identity crisis/psychosocial disintegration, disease complexity, and public unawareness and community problems.Conclusion: There are many negative beliefs and stereotypes about cancer and affected people, which are exacerbated by public unawareness and lack of sufficient information about cancer, as well as lack of comprehensive support. These beliefs and stereotypes adversely affect the quality of life of affected people. Following the findings of the study, some interventions need to be implemented to reduce stigma, increase the quality of life, and improve the treatment process for cancer patients

Patient safety culture in neonatal intensive care units: A qualitative content analysis

BackgroundSafety culture, as an important and influential component of neonatal safety, can lay the ground for the provision of professional and quality care by creating a positive insight among workers. The present study aimed to explain the concept of safety culture and its dimensions from the perspective of the nurses and the physicians working in neonatal intensive care units (NICUs).MethodsThis qualitative directed content analysis study was carried out with 24 NICU physicians and nurses working in Tehran, Iran. These multicenter participants were selected through purposive sampling with maximum diversity in terms of demographic characteristics. The data was collected through in-depth semi-structured interviews and was analyzed using the deductive approach. The COREQ checklist was used for the comprehensive report of this study.ResultsThe concept of patient safety culture in NICUs included achieving professional development, constructive interactions, organizational supportive climate, management's commitment to neonatal safety, planning and implementation of neonatal developmental care, which are extracted from 5 main categories, 10 generic categories and 21 sub-categories.ConclusionThe dimensions of safety culture include procedures that, if promoted, could improve neonatal safety, reducing harm to neonates' health while expending less financial and human resources. Gaining knowledge of the status of these dimensions in wards and hospitals can give a purposeful direction to promote neonate health and policymaking

Iranian senior nursing managers’ experiences and understanding of social capital in the nursing profession

Creative Commons Attribution License. Allows allow anyone to download, reuse, reprint, modify, distribute, and/or copy articles in IJNMR, so long as the original authors and source are cited. No permission is required from the authors or the publishersBackground: This study aimed to explore the role of social capital within the context of the nursing profession in Iran, based on the experience and perspectives of senior nursing managers. Materials and Methods: The study was conducted using the Graneheim and Lundman content analysis method. Using purposive sampling, 26 senior nursing managers from the Ministry of Health and Medical Education, the College of Nursing and Midwifery, the Iranian Nursing Organization, nursing associations and hospitals were selected, who participated in semi-structured in-depth interviews. Results: Content analysis revealed three main themes (social capital deficit, applying multiple strategies, and cultivating social capital) as well as eight categories which included professional remoteness, deficiency in professional potency, deficiency in professional exchanges, accumulation of personal social capital, accumulation of professional social capital, socio-political strategies, psychological–cognitive strategies, and ethical/spiritual strategies. The results show the perceived level of social capital in nursing in Iran, the application of some key strategies, and the principal rewards accrued from active participation in improving the social capital in nursing environment and profession. Conclusions: Efforts should be made to strengthen the social capital and apply key strategies with the aim of achieving personal and professional benefits for nurses, their patients, and co-workers, and for the delivery of healthcare in general. In this respect, the role of senior managers is vital in stimulating collective action within the profession, planning for the development of a culture of participation in healthcare services, helping to develop all fields of the profession, and developing and strengthening intra- and inter-professional exchanges and networking

Non-Traditional Roles of Iranian Senior Nurse Managers in Developing the Profession: A Qualitative Study

This work is licensed under a Creative Commons Attribution 3.0 License.Background The traditional roles of managers are insufficient in today’s evolving healthcare market. Therefore, they need to improve management practices through playing new roles. So the present study aimed to explore the roles of nurse managers in the context of Iranian health care system. Methods A qualitative content analysis with semi-structured interviews was used in this study. The study settings included the Ministry of Health and Medical Education, Nursing and Midwifery Schools, public hospitals, and Nursing Associations in Tehran, Iran. A purposive sample of twenty six nurse managers was recruited in this study. Results The main theme found was “socio-political roles”, with the five subcategories as roles: “managing boundaries”, “integrator”, “convincing agent of change”, “governance of the profession”, and “promotion of the profession”. The study indicated by playing socio-political roles nurse mangers gained many advantages for the profession. Conclusion While studies have focused on the traditional roles of nursing managers, the concept of socio-political roles opens a new field of work. Hence, should be made to pay close attention to the significant roles of nursing managers in the current context of health care. In keeping pace with changes and by enacting their socio-political roles, nursing managers can facilitate the achievement of major professional and healthcare goals

The Organizational Internal Environment as an Effective Factor for

AbstractBackground and AimThe internal environment of any organization is an effective factor on change management. Thereare many effective factors which should be determined and utilized for change management in anyorganization including nursing and midwifery schools. So, this study aimed to exploreorganizational internal environment of nursing and midwifery schools and it's effect on changemanagement.Materials and methodsThis study was the qualitative part of a mixed exploratory study. The participants were recruited bypurposeful sampling method from the managers of Tehran schools of nursing and midwifery. Datawere gathered by semi-structured interviews andconventional content analysis was used for dataanalysis.FindingsTotally, 171 conceptual codes were extracted which were categorized in 3 themes includingchanging process, internal organizational environment and external organizational environment.Internal organizational environment had 10 subcategories in 3 main categories includingmanagerial-, organizational- and individual-factorsConclusion:The concept of change management is a complicate procedure which is influenced bymanagerial-, organizational- and individual-factors. Faculty members, manager's duties, education,attitude and other factors should be considered for change management in schools of nursing andmidwifery.Keywords:Change management, Change, Nursing school.*Corresponding Author: Alice Khachian, Ph.D student of nursing, School of Nursing & Midwifery,Shahid Beheshti University of Medical SciencesE-mail : [email protected] P (2007). A Fifth Discipline Resource: Dance of Change. Translated by Akbari H Soltani M. Tehran. AryanaIndustrial & Research Group. (Persian)-Andrew J Cameron H Harris M (2008). All Change? Managers’ experience of organizational change in theory andpractice. Journal of Organizational Change Management. 21 (3) 300-314.-Bianco A Schermerhorn J J(2006). Self-regulation, strategic leadership and paradox in organizational change. Journalof Organizational Change Management. 19(4)457-470.-Boswell C Cannon SH (2007). Introduction to Nursing Research: Incorporating Evidence-Based Practice. 2nd edition.Boston, Jones and Bartlett Publisher.-Gatto RP (2000). The Smart Manager's F.A.Q. guide: A Survival Handbook for Today's Workplace. San Francisco,Jossey- Bass.-Hsieh H Shannon SE (2005). Three approaches to qualitative content analysis. Qualitative Health Research. 15(9)1277-88.-Johansson C, Heide M (2008). Speaking of Change: Three Communication Approaches in Studies of OrganizationalChange. Corporate Communications: An International Journal. 13(3) 288-305.-Kordrostami M Aghakhani E (2006) [Change Management and Organizational Development]. Tehran, Darsi booksPublication. (Persian).-LoBiondo–Wood G, Haber J (2002) Nursing Research: Methods, Critical Appraisal and Utilization.6th Edition. USA,Mosby.-McCormick D (2007) Dramaturgical analysis of Organizational Change and Conflict. Journal of OrganizationalChange Management. 20(5)685-699.-David R (2009). [Strategic Management]. Translated by parsayan A, Aarabi M. Iran cultural Studies (Persian).-Reed J Vakola M (2006). What role can a training needs analysis play in organizational change. Journal ofOrganizational Change Management. 19 (3) 393-407.- Sadeghi D (2011). Alignment of organizational change strategies and its relationship with increasing organizations'performance. Procedia Social and Behavioral Sciences 20,1099-1107.-Saka A (2003). Internal Change Agents' View of the Management of Change Problem. Journal of OrganizationalChange Management. 16 (5) 480-496.-Salsali M Parvizi S Adib Hajbagheri M(2004). [Qualitative Research Methods]; 1st edition, Tehran BoshraPublications. (Persian).-Streubert Speziale HJ, Carpenter Rinaldi D(2007). Qualitative Research in Nursing, Advancing the HumanisticImperative. 4th edition. Philadelphia, Lippincott-Williams &Wilkins.-Van Dijk R Van Dick R (2009).Navigating Organizational Change: Change Leaders, Employee Resistance and Work-Based Identities. Journal of Change Management. 9(2)143-63

Opinions of Educational Experts in Shahid Beheshti University of

Background and aim: Education and clinical application of basic science is important in nursing education ,nurse educators have reported problems with the teaching and learning of bioscience. This study aimed toexplore educational expert’s opinions regarding the basic science courses offer.Materials and methods: This descriptive study was performed on 35 educational experts at Faculty ofNursing and Midwifery, Shahid Beheshti University of Medical Sciences. Data were collected with a semistructuredquestionnaire. Face and content validity were checked. The reliability of the questionnaire wasdetermined using the Cronbach’s Alpha test. Data were analyzed by SPSS(version 18) and descriptivestatistics.Findings: 50.0 percent of educational experts agreed with the proportion of basic science courses for nursingcourse objectives. Also, they agreed with time extension for anatomy and physiology courses, especially thesecourses offer in several semesters and relevant to clinical nursing courses.Conclusion: According to the results, it seems that curriculum planners should investigate about the clinicalapplication of basic science courses in nursing program as a priority, and fundamental reform needs toconsider basic science courses offer, especially anatomy and physiology, as well.Keywords: Curriculum planning, Educational Experts, Nursing education, Basic science course

Developing a tool for evaluation of causes of futile care in intensive care units

Background: In Iran, futile care has become a challenge for intensive care nurses. The aim of the study was to develop a tool for assessing the reasons of futile care at intensive care units (ICUs). Materials and Methods: A sequential mixed method in three stages was applied. In the first stage, a phenomenological study was performed with van Manen's method by interviewing 25 nurses at ICUs of 11 hospitals in Qazvin. To extract the items of the tool in the second stage, the concept of futile care in ICUs and its reasons were defined. Ultimately, the psychometric properties of the questionnaire were evaluated with face validity, content validity (quantitative and qualitative), construct validity (exploratory factor analysis), internal consistency (Cronbach's alpha), and test–retest reliability. Results: The initial tool had 119 questions. After validation, 39 items remained in the final questionnaire. Five extracted factors were as follows: professional competence (14 items), organizational policy (9 items), socio-cultural factors (7 items), personal beliefs and values (4 items), and legal issues (5 items). Cronbach's alpha for the whole questionnaire was 0.91 (range: 0.71–0.96). The test–retest reliability was 0.87 (p < 0.001). Conclusions: Nursing managers and clinical nurses can use this tool to identify the causes of futile care and reduce it in their clinical settings. Policy makers can use this tool for improving the management of ICUs