Cost analysis - the desirability of natural delivery and caesarean section with decision tree model

Objective: This article deals with the cost-benefit analysis of natural childbirth and caesarean section with decision tree model. Methods: This is a practical study in which 644 cases of natural and cesarean births (including 317 natural births and 327 cesarean births) were extracted and included in the relevant list. Then mothers who had been at least 3 months after giving birth were included in the study. The data was collected using the researcher's checklist and EQ-5D-3L structured questionnaire by the researcher. SPSS 26 and R Core Team (2021) software were used to perform the analysis. Results: Natural childbirth was more prevalent for pregnant women compared to cesarean delivery. which had a lower cost (26980930.90±16603206.35 Rials vs. 48883938.59 ± 6126709.15 Rials) and better utility (86.91± 4.353vs. 64.16±7.348) for all evaluated outcomes. Conclusions: It is necessary to control and manage cesarean section in cases without clinical indication. Also, other low-cost and easy-to-access strategies should be carried out for the awareness of mothers and cultural and legal foundation in the field of promoting natural childbirth

A Study on the Status of Error Reporting Cultures among Nurses in Medical Sciences Hospitals of Islamic Azad University

Background:One of the goals of nursing is to provide safe patient care and medical errors are one of the most important threats in this field.Therefore, the purpose of this study is to assess the status of error reporting culture and determine its relationship with demographic characteristics.Methods:This descriptive,analytical and cross-sectional study was carried out among 239 nurses of amiralmomenin and bouali hospitals. First,face validity and then content validity were performed by 15 nursing experts and the questionnaire was distributed and collected. The normal distribution of data was confirmed by Kolmogorov-Smirnov test. The reliability and construct validity were performed with Cronbach’s Alpha test and exploratory factor analysis by PCM.The status of reporting culture was determined by computing descriptive statistics and its relation with demographic variables with Pearson correlation test and logistic regression test with SPSS software version 16.Results:The content validity with CVR &CVI of 0.820 and 0.920 were confirmed. The reporting culture was favorable with a mean and standard deviation of 2.674 and 0.475.The reliability with Cronbach's alpha of 0.747 and the construct validity with a KMO of 0.727 and Significance of the Bartlett test were confirmed and 3 subscales were extracted. The relationship between age and work experience with the reporting culture with a correlation of 0.009 and 0.013 with a significant < 0.05 were rejected But with the variable of gender(=female) with a chance of 2.536 and the significant of 0.006 was confirmed.Conclusion:Developing a safety culture in hospitals by implementing various health programs improves the reporting culture,but the mental climate is undesirable and requires major steps to reduce worries and negative outcomes after reporting.The presence of female nurses in comparison with men improves the error reporting culture.Perhaps the main reason is patriarchy in Iranian culture

Studying the effect of artificial intelligence on improvement of various quality criteria in relation to audit work in Iran

Considering huge volume of data and increasing trend of artificial intelligence technology in all of the scopes, classic auditing methods are insufficient; so, using artificial intelligence in the audit field has gained special importance. The study has been performed to the aim of studying the effect of artificial intelligence on quality of audit work in Iran. Also, the reasons for lack of tendency of Iranian auditors to use artificial intelligence technology have been reviewed. Data have been collected through questionnaires provided to 150 auditors and managers being accepted upon inclusion criteria. Four research hypotheses have been analyzed through statistical tests. The research results showed that applying artificial intelligence along with data analyses related to items in financial statements, fraud detection, and slight audit cost reduction have positive effect on improvement of audit work’s quality. Finally, it is advised that following points would be taken into consideration as for development of artificial intelligence in the field of auditing: strengthening professional capability of auditors in relation to artificial intelligence skills and knowledge; providing required substructure as for usage to be made of artificial intelligence in the field of auditing; and creating trust in auditors to use such technology

Avaliação da segurança do paciente com covid-19 em comparação com o paciente sem covid-19 e fatores predisponentes de erros de enfermagem

Objectives: The present study aims to determine Patient Safety in hospitalized patients with COVID-19 compared to non-COVID-19 ones and find predisposing factors of nursing errors according to nurses’ perceptions. Methods: This descriptive-comparative research employed data from 800 nurses in eight Iranian hospitals in 2021 using three researcher-made questionnaires of sociodemographic, patient safety indicators, and predisposing factors of nursing errors, with high reliability and validity. The collected data were analyzed using ANOVA, independent t-test, and the SPSS22 software. Results: The mean patient safety scores in patients with and without COVID-19 were 3.42 ± 0.17 and 3.74 ± 0.06, respectively. The highest differences in patient safety were attributed to infection control (0.66) and patient fall (0.56) dimensions. The most common causes of nursing errors were related to management (2.67 ± 1.39), and the most common predisposing factors of nursing errors were high workload, low ratio of nurses to patients, and fatigue. Conclusions: COVID-19 patients have lower safety than non-COVID ones. Also, improper management and high workload lead to nursing errors. Therefore, the authorities must devise appropriate strategies to reduce the nurses’ workload and improve patient safety, especially in COVID-19 patients.Objetivos: el presente estudio tuvo como objetivo determinar la seguridad en pacientes hospitalizados con covid-19 en comparación con los que no tenían covid-19 y encontrar factores predisponentes de errores de enfermería según la percepción de los enfermeros. Métodos: esta investigación descriptiva-comparativa empleó datos de encuestas de 800 enfermeros en ocho hospitales iraníes en 2021 mediante tres cuestionarios con alta confiabilidad y validez elaborados por investigadores que incluían datos sociodemográficos, indicadores de seguridad del paciente y factores predisponentes de errores de enfermería. Los datos recopilados se analizaron mediante ANOVA, prueba t independiente y el software SPSS22. Resultados: las puntuaciones medias de seguridad de los pacientes con y sin covid-19 fueron 3,42 ± 0,17 y 3,74 ± 0,06, respectivamente. Las mayores diferencias en seguridad del paciente se atribuyeron a las dimensiones de control de infecciones (0,66) y caída del paciente (0,56). Por otra parte, las causas más comunes de los errores de enfermería estuvieron relacionadas con el aspecto gerencial (2,67 ± 1,39), y los factores predisponentes más comunes de los errores de enfermería fueron la alta carga de trabajo, la baja proporción de enfermeros por pacientes y la fatiga. Conclusiones: los pacientes con covid-19 tienen menor seguridad que los que no presentan la enfermedad. Además, la gestión inadecuada y la alta carga de trabajo conducen a errores de enfermería. Por lo tanto, las autoridades deben diseñar estrategias adecuadas para reducir la carga de trabajo de los enfermeros y mejorar la seguridad del paciente, en especial en aquellos con covid-19.Objetivo: o objetivo deste estudo foi determinar a segurança em pacientes internados com covid-19 em comparação com os que não tinham covid-19 e encontrar fatores predisponentes de erros de enfermagem segundo a percepção de enfermeiros. Materiais e método: trata-se de pesquisa descritivo-comparativa, que utilizou dados de pesquisas com 800 enfermeiros em oito hospitais iranianos em 2021, com base em três questionários com alta confiabilidade e validade, elaborados por pesquisadores, que incluíam dados sociodemográficos, índices de segurança do paciente e fatores predisponentes de erros de enfermagem. Os dados coletados foram analisados com ANOVA, teste t independente e software SPSS22. Resultados: as pontuações médias de segurança dos pacientes com e sem covid-19 foram 3,42 ± 0,17 e 3,74 ± 0,06, respectivamente. As maiores diferenças em segurança do paciente foram atribuídas às dimensões de controle de infecções (0,66) e queda do paciente (0,56). As causas mais comuns dos erros de enfermagem estiveram relacionadas com o aspecto gerencial (2,67 ± 1,39) e os fatores predisponentes mais comuns dos erros de enfermagem foram a alta carga de trabalho, a baixa proporção de enfermeiros por paciente e a fadiga. Conclusões: os pacientes com covid-19 têm menor segurança do que os que não apresentam a doença. Além disso, a gestão inadequada e a alta carga de trabalho levam a erros de enfermagem. Portanto, as autoridades devem elaborar estratégias adequadas para reduzir a carga de trabalho dos profissionais de saúde e melhorar a segurança do paciente, em especial daqueles com covid-19

Evaluación de la seguridad del paciente con COVID-19 en comparación con pacientes sin COVID-19 y factores predisponentes de los errores de enfermería

20 páginasObjectives: The present study aims to determine Patient Safety in hos-pitalized patients with COVID-19 compared to non-COVID-19onesand find predisposing factors of nursing errors according to nurses’ perceptions. Methods: This descriptive-comparative research em-ployed data from 800 nurses in eight Iranian hospitals in 2021 using three researcher-made questionnaires of sociodemographic, patient safety indicators, and predisposing factors of nursing errors, with high reliability and validity. The collected data were analyzed using ANO-VA, independent t-test, and the SPSS22 software. Results: The mean patient safety scores in patients with and without COVID-19 were 3.42 ± 0.17 and 3.74 ± 0.06, respectively. The highest differences in patient safety were attributed to infection control (0.66) and patient fall (0.56) dimensions. The most common causes of nursing errors were related to management (2.67 ± 1.39), and the most common predisposing fac-tors of nursing errors were high workload, low ratio of nurses to pa-tients, and fatigue. Conclusions: COVID-19 patients have lower safety than non-COVIDones. Also, improper management and high workload lead to nursing errors. Therefore, the authorities must devise appro-priate strategies to reduce the nurses’ workload and improve patient safety, especially in COVID-19 patients.Objetivos: el presente estudio tuvo como objetivo determinar la se-guridad en pacientes hospitalizados con covid-19 en comparación con los que no tenían covid-19 y encontrar factores predisponen-tes de errores de enfermería según la percepción de los enferme-ros. Métodos: esta investigación descriptiva-comparativa empleó datos de encuestas de 800 enfermeros en ocho hospitales iraníes en 2021 mediante tres cuestionarios con alta confiabilidad y validez elaborados por investigadores que incluían datos sociodemográfi-cos, indicadores de seguridad del paciente y factores predisponen-tes de errores de enfermería. Los datos recopilados se analizaron mediante ANOVA, prueba t independiente y el software SPSS22. Resultados: las puntuaciones medias de seguridad de los pacientes con y sin covid-19 fueron 3,42 ± 0,17 y 3,74 ± 0,06, respectivamente. Las mayores diferencias en seguridad del paciente se atribuyeron a las dimensiones de control de infecciones (0,66) y caída del pacien-te (0,56). Por otra parte, las causas más comunes de los errores de enfermería estuvieron relacionadas con el aspecto gerencial (2,67 ± 1,39), y los factores predisponentes más comunes de los errores de enfermería fueron la alta carga de trabajo, la baja proporción de enfermeros por pacientes y la fatiga. Conclusiones: los pacientes con covid-19 tienen menor seguridad que los que no presentan la enfermedad. Además, la gestión inadecuada y la alta carga de tra-bajo conducen a errores de enfermería. Por lo tanto, las autoridades deben diseñar estrategias adecuadas para reducir la carga de traba-jo de los enfermeros y mejorar la seguridad del paciente, en especial en aquellos con covid-19.Palabras clave (Fuente: DeCS)Covid-19; errores médicos; enfermera; seguridad del paciente; aislamiento de pacientes.Evaluación de la seguridad del paciente con COVID-19 en comparación con pacientes sin COVID-19 y factores predisponentes de los errores de enfermerí

Examining the indices and the factors affecting agility of hospitals: Case study Shahid Rejaei Hospital

In the everchanging world of today, the proper management and administration of the challenges faced by the organizations is of the key goals aiming to successfully deal with continuous, dynamic, and unpredictable environmental changes. Thus, an organization is known as agile that can have such management. The purpose of the study was to examine the indices and factors affecting the agility of hospitals in Shahid Rejaei Hospital. The study was exploratory-mixed carried out qualitatively (interview) and quantitatively (correlation), which was applied in terms of purpose, and survey method was used for data collection. Regarding this, Shahid Rejaei Hospital was selected as the population. SPSS and EXCEL software was used for statistical calculations. The results, in an applied way, formed other part of the paper by using various methods of descriptive and inferential statistics as analytical tables that tests the hypotheses. Finally, some suggestions and solutions were presented in form of summary and conclusion of the paper according to the results of statistical tests

The Effect of transcranial Direct Current Stimulation (tDCS) on Opioid Craving: Effect of tDCS on Opioid Craving

Introduction: Nowadays, substance use disorder is one of the most serious health problems in the world. Craving is one of the leading causes of substance use relapse. The purpose of this study was to evaluate the effect of transcranial Direct Current Stimulation (tDCS) on participants with opioid substance use disorder. Materials and Methods:  A randomized, sham-controlled trial was carried out to evaluate the effect of dorsolateral prefrontal cortex stimulation (right anodal and left cathodal) on craving among participants with opioid use disorder. Eighteen men were categorized into sham tDCS and active tDCS groups. Interventions were performed for seven consecutive days. In both groups, the instantaneous and periodic craving was evaluated by the Desire for Drug Questionnaire (DDQ) and Obsessive Compulsive Drug Use Scale (OCDUS) before and a week after the interventions. The differences between the two groups were evaluated by paired samples t-test and student's t-test. Results: The results indicated that tDCS significantly reduced the scores on DDQ and OCDUS in the active tDCS group compared to the sham tDCS group (P<.05). Conclusions: Our findings provide support for applying tDCS in controlling opioid craving. Therefore, this method can be considered to be a new therapeutic approach in treatment of opioid use disorder