The Impact of Training on Medication Error Rate of the Emergency Department in Hospitals Affiliated to Golestan University of Medical Sciences

AbstractIntroduction: Medication errors are the most common type of medical errors that cancause serious problems for public health and are considered a threat to patient safety.This study was conducted to determine the effectiveness of patient safety trainingon nurses’ medication errors at the emergency department of a hospital of GolestanProvince in Iran.Methods: The present quasi-experimental study was conducted from March toSeptember 2016. The study population consisted of nurses working at a hospitalaffiliated to Golestan University of Medical Sciences and a sample of 40 nurses atthe emergency department of this hospital were selected through a census. Thedata collection tools used included a demographic questionnaire and Wakefield’sMedication Error questionnaire for nurses (consisting of 21 domains), which wereused once their reliability was confirmed. A patient safety training program wasdesigned and implemented for the selected emergency nurses in the form of a twodayworkshop. The obtained data were analyzed using the SPSS-18 software with theWilcoxon test.Results: Results showed that the rate of medication errors (80.62%) of nurses wereat a low level. The majority of nurses (80.62%) scored low in terms of the frequencyof medication errors; after the training, a significantly greater number of nurses scoredlow in terms of this index (90.31%; P < 0.001). The analyses showed the effectivenessof the patient safety training program for nurses in the two domains of wrong timeerror and missed dose error (P < 0.001); however, the training had no significant effects in the other domains.Conclusions: As patient safety training can be effective on nurses’ medication errors,retraining courses on safe medication administration are necessary regarding nurses’significant role in the prevention of medication errors

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

Spiritual Leadership Model as a Paradigm for Nursing Leadership: A Review Article

AbstractIntroduction: The aim of this study was to explain how the spiritual leadership modelcould be used as a paradigm for nursing leadership. Nursing leaders play a critical rolein the management of the health care system. Spiritual leadership is a new area that hasrecently been considered in nursing management.Methods: In this review article, electronic databases (PubMed, Scopus, GoogleScholar and Science Direct) were searched from September 2014 to July 2016 to findrelevant articles using keywords, such as spirituality, leadership, management, nursesand motivation. In this regard, the articles that fulfilled the goals of the study that werewritten in English or Persian, had their full texts accessible, and were published in theintended time interval were entered in the study. The articles without authors’ namesand dates and non-scientific papers were excluded from the study. On the whole, a totalof 120 articles were obtained, of which 48 were selected and analyzed.Results: A review of the literature focusing on spiritual leadership demonstrated thatthe spiritual leadership model has been examined in different countries, various fieldsof the industry, trade training, and the health system with positive individual andorganizational consequences. It seems that the characteristics of this style of leadershipfits the nursing profession as well. Of course, more large-scale future studies for testingthis model of leadership in the field of nursing will bring about more promising results.Conclusions: Spiritual leadership could improve the organizational productivity andemployees’ satisfaction. Nursing leaders should have paid greater attention to this typeof leadership to achieve positive organizational outcomes; therefore, they need moretraining in this issue.

Correlation between Spiritual Leadership and Occupational Conflict

Abstract Introduction: Nurses as the largest group among the healthcare staff sustain continual environmental pressures and changes. Hence, the incidence of conflict among nurses is something normal due to extensive interactions with various people. Managers can make the organizational activity more effective and efficient by the use of innovative leadership styles based on internal motivation and appropriate management of conflict. This study determined the correlation between spiritual leadership and occupational conflict of nurses employed at selected academic hospitals affiliated to Shahid Beheshti University of Medical Sciences in 2017. Methods: 287 nurses employed at various wards of academic hospitals of Shahid Beheshti University of Medical Sciences, Tehran, Iran, were enrolled in this descriptive-correlational study using convenient sampling method. The data were collected using two questionnaires; “Spiritual Leadership” and “Occupational Conflict” and analyzed with SPSS.18. Results: 261 nurses completed questionnaires and resend them. The findings showed that the maximum score obtained by nurses about their head nurse’s spiritual leadership style belonged to “altruistic love” (14.46 out of 25). In addition, the highest score about their occupational conflict belonged to “interclass conflict” (10.98 out of 16). Generally, there was a significant correlation between spiritual leadership and occupational conflict (P<0.001, r=0.522). Conclusions: The findings on the correlation between the nurses’ perspectives about spiritual leadership and occupational conflict indicated that the application of innovative styles such as spiritual leadership to reduce nurses’ occupational conflict in the Iranian healthcare system demands more investigations. It can serve as the managers’ guide in choosing the most effective leadership style to diminish occupational conflict among nurses and reach the highest levels of outcomes in the organization

The Concept of Nursing Care Quality from the Perspective of Stakeholders: A Phenomenological Study

Introduction: Quality in health care has various aspects, definitions, and interpretations. According to diverse definitions of nursing care quality in different cultures, this study explored the meaning of nursing care quality from the stakeholders’ point of view. Method: This study employed a hermeneutic phenomenological approach to depict the lived experiences of nurses, doctors, and patients and their relatives about nursing care quality. Data was collected through deep individual interviews and observasions. The collected data was then analyzed using Diekelmann’s seven-stage method. Results: We performed individual interviews with six doctors, 10 nurses, and 22 patients. Moreover, 20 patient relatives were interviewed in a focus group. The first stage of data analysis revealed 2312 initial codes. The ongoing process of analysis, comparison, and reductions resulted in a final number of five themes and 22 subthemes. Doctors, nurses, and patients and their relatives defined the concept of nursing care quality as “meeting the needs of patients through purposeful care and appropriate relationships, support, mutual respect, responsibility, and accountability”. Conclusion: Nursing managers must identify strategies to support and provide better nursing care which reflects purposeful care, nursing responsibility, appropriate relationships, and patient respect and support for all clients. These findings may also be used by nursing educators to improve nursing curricula. Keywords: Nursing care quality, Hermeneutic phenomenology, Nurse, Doctor, Patient

Nurses’ Turnover Process: A Qualitative Research

Introduction: The shortage of nurses and nursing turnover are major problems in the most countries of the world and Iran accordingly. Nurses' turnover is taken place during a process. The present study aimed to describe how nurses’ turnover process is carried out. Method: The nurse's turnover was studied from the perspective of 16 nurses with basic grounded theory. The participants were selected through conventional and theoretical sampling method. The data were collected by semi-structured interviews. The data were analyzed simultaneously by continuously comparisons based on Strauss and Corbin 2008 method. Results: Thinking about nursing “turnover” was appeared as the main variable which affects nurses' turnover process. The main variable in this study included six axial codes: professional/managerial challenges, finding a solution, thinking about turnover, job seeking, turnover intention, and conducting turnover. Conclusion: In order to prevent nursing turnover, identifying facilitating factors, removing barriers and promoting the necessary facilities are necessary. Keywords: Process, Turnover, Nurse, Grounded theor

Concept development of compassion fatigue in clinical nurses: Application of Schwartz-Barcott and Kim\u27s hybrid model

Compassion fatigue is not a new concept in nursing; yet, it is not well known and there is no fixed clear definition of the term. The ambiguity surrounding how to define compassion fatigue has challenged its measurement and evaluation. Thus, any attempt to determine attributes of this underdeveloped concept and studying it in a new socio-cultural context requires concept development. The purpose of this study is to clarify the concept of compassion fatigue through concept development and to produce a vivid and tentative definition of this concept in clinical practice. Concept development was conducted using a three-step hybrid concept analysis including theoretical, fieldwork, and final analysis phases according to Schwartz-Barcott and Kim\u27s method. We reviewed and analyzed 48 articles that met the inclusion criteria. Following, the first author conducted 13 interviews with clinical nurses followed by an inductive content analysis. Finally, a comprehensive definition of compassion fatigue in nurses was attained. Compassion fatigue in nurses can be explained as a cumulative and progressive process of absorption of the patient’s pain and suffering formed from the sympathetic and caring interactions with the patients and their families. The physical, emotional, intellectual, spiritual, social, and organizational consequences of compassion fatigue are so extensive that they threaten the existential integrity of the nurse. Context-based variables (culture, family, and community) such as personality features like devotion behaviors and commitment towards the patient, exposure to multiple stressors, organizational challenges, and lack of self-care are factors associated with an increased risk of compassion fatigue. Concept development of compassion fatigue is the first step in the protection of nurses against the destructive consequences of compassion fatigue and to improve quality of care

Correlation between Demographic Information and Rate of Conflict among Nurses in Emergency Department

AbstractIntroduction: The conflict phenomenon has been always problematic in the health system leading to reduced efficiency of the staff and increased health care costs. Conflicts in the hospital are high due to frequent interactions among nurses, physicians, and other members of the treatment team and their multiple roles. This study expunged upon the correlation between demographic information and the rate of conflict among the nurses in the emergency department (ED). Methods: A total of 147 nurses of teaching hospitals affiliated to Shahid Beheshti University of Medical Sciences participated in this descriptive-analytic study in October, 2015. The nurses were selected using the random cluster sampling method. The data were collected with a researcher-made instrument. The gleaned data were analyzed with descriptive statistics, Pearson product moment correlation coefficient, and one-way ANOVA. Results: Our findings demonstrated that the rate of conflict was higher in the intrapersonal dimension in nurses employed in ED of the hospitals under study compared to the other two dimensions, i.e., intraclass and interclass. There was significant correlation between gender and rate of conflict in intrapersonal and interclass dimensions while the rate of conflict was higher among the males than females. There was also a significant association between the rate of conflict in intraclass dimension and employment status. Conclusions: The results of this study can help managers to remove or diminish conflict-inducer factors. They may further adopt appropriate methods to manage conflict and promote nursing services through cooperative and supportive interaction

Compassion Fatigue in Clinical Nurses: An Evolutionary Concept Analysis

Background: Despite the agreement regarding the significance of the concept of CF in nursing, it has been unrecognized, and there is no clear definition of compassion fatigue in the context of nursingObjectives: The aim of this study is to inductively develop or formulate a clear and uniformed definition of compassion fatigue in the context of nursing.Patients and Methods: A Concept analysis using Rodger’s approach using a literature-based method and thematic analysis was conducted. Steps of Rodger’s concept analysis encompass identify the concept and associated definition, attributes, antecedents, consequences, surrogate terms, related concepts, and a model case exemplar.Results: attributes, antecedents and consequences of compassion fatigue from literatures is extracted and then a vivid definition is achieved.Conclusions:this analysis demonstrated that the concept of compassion fatigue is comprised of excessive empathy, the symptomatology of secondary traumatic stress, the problematic work environment of burnout and coping mechanism deficit. Keywords: Compassion fatigue, Secondary traumatic stress, nurse, concept analysi