Environmental Impact Assessment of Irrigation and Drainage Network Using the Conventional and Modified ICOLD Matrix Methods

With respect to the importance and considerable extent of the Kosar irrigation and drainage network, the environmental issues of the network are investigated. The purpose of this study was to evaluate the environmental effects of Kowsar irrigation and drainage network located in the central basin of Karkheh in Khuzestan province, using two methods: conventional and modified ICOLD matrices. To study the environmental parameters, three physical, biological and socio-economic environments were used. Then, using two methods of conventional and modified ICOLD matrices, the effect of each of the project micro-activities on the environmental factors of the study area was measured in the operation phase separately for the three mentioned environments. Thus, a matrix was designed according to all three environments, which was completed by environmental experts and the average score of the evaluation criteria was considered. The results showed that the most positive effects are related to the socio-economic environment. It should be noted that the sum of positive values using conventional and modified ICOLD matrices was 793 and 458.9, respectively, and for negative values was 447 and 285.8, respectively. Therefore, both matrices showed reasonable and good fitness in estimating the impacts and thus the implementation of the Kawser irrigation and drainage network is verified

Validating and determining the weight of items used for evaluating clinical governance implementation based on analytic hierarchy process model

Background: The purpose of implementing a system such as Clinical Governance (CG) is to integrate, establish and globalize distinct policies in order to improve quality through increasing professional knowledge and the accountability of healthcare professional toward providing clinical excellence. Since CG is related to change, and change requires money and time, CG implementation has to be focused on priority areas that are in more dire need of change. The purpose of the present study was to validate and determine the significance of items used for evaluating CG implementation. Methods: The present study was descriptive-quantitative in method and design. Items used for evaluating CG implementation were first validated by the Delphi method and then compared with one another and ranked based on the Analytical Hierarchy Process (AHP) model. Results: The items that were validated for evaluating CG implementation in Iran include performance evaluation, training and development, personnel motivation, clinical audit, clinical effectiveness, risk management, resource allocation, policies and strategies, external audit, information system management, research and development, CG structure, implementation prerequisites, the management of patients’ non-medical needs, complaints and patients’ participation in the treatment process. The most important items based on their degree of significance were training and development, performance evaluation, and risk management. The least important items included the management of patients’ non-medical needs, patients’ participation in the treatment process and research and development. Conclusion: The fundamental requirements of CG implementation included having an effective policy at national level, avoiding perfectionism, using the expertise and potentials of the entire country and the coordination of this model with other models of quality improvement such as accreditation and patient safet

Medication Errors and its Contributing Factors among Midwives

Introduction: Medication errors are among the most serious health errors threatening patient safety in all countries, with major impacts on public health. Midwives as members of healthcare systems are prone to such errors. Therefore, in this study, we aimed to determine medication errors and the contributing factors among midwives working in maternity units of Mashhad University of Medical Sciences, Mashhad, Iran in 2015. Methods: This descriptive, cross-sectional study was performed on 104 employed midwives at four hospitals (Imam Reza, Ghaem, Omolbanin, and Hashemi Nezhad hospitals), affiliated to Mashhad University of Medical Sciences. The validity and reliability of the data collection tools were confirmed through content validity and internal consistency (Cronbach's alpha), respectively. For data analysis, descriptive and analytical tests, multiple linear regression, and negative binomial regression analysis were performed, using SPSS version 20 and STATA version 11. Results: The average incidence of medication errors for each midwife was 21.24±2.89 in the past six months. Among reasons against reporting medication errors, fear of confrontation with authorities (3.79±1.5) and attributing the medication error to individual factors by officials (3.88±1.34) had the highest average scores. The most common causes of medication errors were overcrowding of the ward (4.32±1.01), excessive workload and overexertion (4.19±1.08), and presence of critically ill patients in the ward (4.03±1.18). Conclusion: Overcrowding of the ward, fear of authorities, and attributing the medication error to individual factors were the main reasons against reporting medication errors, respectively. Therefore, more attention should be paid to error reporting systems, and workshops in this area are highly recommended

Evaluation Systems for Clinical Governance Development: a Comparative Study

Lack of scientific and confirmed researches and expert knowledge about evaluation systems for clinical governance development in Iran have made studies on different evaluation systems for clinical governance development a necessity. These studies must provide applied strategies to design criteria of implementing clinical governance for hospital's accreditation. This is a descriptive and comparative study on development of clinical governance models all over the world. Data have been gathered by reviewing related articles. Models have been studied in comprehensive review method. The evaluated models of clinical governance development were Australian, NHS, SPOCK and OPTIGOV. The final aspects extracted from these models were Responsiveness, Policies and Strategies, Organizational Structure, Allocating Resources, Education and Occupational Development, Performance Evaluation, External Evaluation, Patient Oriented Approach, Risk Management, Personnel's Participation, Information Technology, Human Resources, Research and Development, Evidence Based Medicine, Clinical Audit, Health Technology Assessment and Quality. These results are applicable for completing the present criteria which evaluating clinical governance application and provide practical framework to evaluate country's hospital on the basis of clinical governance elements

Validating and Determining the Weight of Items Used for Evaluating Clinical Governance Implementation Based on Analytic Hierarchy Process Model

Background: The purpose of implementing a system such as Clinical Governance (CG) is to integrate, establish and globalize distinct policies in order to improve quality through increasing professional knowledge and the accountability of healthcare professional toward providing clinical excellence. Since CG is related to change, and change requires money and time, CG implementation has to be focused on priority areas that are in more dire need of change. The purpose of the present study was to validate and determine the significance of items used for evaluating CG implementation. Methods:The present study was descriptive-quantitative in method and design. Items used for evaluating CG implementation were first validated by the Delphi method and then compared with one another and ranked based on the Analytical Hierarchy Process (AHP) model. Results:The items that were validated for evaluating CG implementation in Iran include performance evaluation, training and development, personnel motivation, clinical audit, clinical effectiveness, risk management, resource allocation, policies and strategies, external audit, information system management, research and development, CG structure, implementation prerequisites, the management of patients’ non-medical needs, complaints and patients’ participation in the treatment process. The most important items based on their degree of significance were training and development, performance evaluation, and risk management. The least important items included the management of patients’ non-medical needs, patients’ participation in the treatment process and research and development. Conclusion:The fundamental requirements of CG implementation included having an effective policy at national level, avoiding perfectionism, using the expertise and potentials of the entire country and the coordination of this model with other models of quality improvement such as accreditation and patient safety

The Relationship between Motivation and Academic Burnout among Students of Health School, Mashhad University of Medical Sciences

Introduction: Due to increasing number of universities in recent years and lack of adequate attention to quality and standards of education, academic burnout has become a problem which is predicted to be intensified in future. Thus this study was done to determine the relationship between motivation and academic burnout among students of Health School of Mashhad University of medical sciences, 2015. Methods: This cross-sectional study was conducted on 262 students of health school. Two standard questionnaires of including Harter Motivation scale (1981) and Berso academic burnout questionnaire (1997) were used. The data was analyzed using SPSS 16. Results: The findings showed a significant inverse correlation between motivation and burnout (r=- 0/503), Also a significant relationship between motivation and exhaustion (r=-0/425), cynicism(r=-0/445), reduced efficiency(r=-0/397) was found (P Value < 0/01). Conclusion: based on the findings, enhancing academic motivation can help reduce burnout, so educational deputies and others who are officially responsible should plan and create proper frameworks for betterment

The Relationship between Organizational Citizenship Behavior, Job Satisfaction, and Occupational Stress among Midwives Working in Healthcare Centers of Mashhad, Iran, 2014

Background & aim: Organizational citizenship behavior (OCB) is a voluntary, organizationally desirable action that is not part of the employee’s formal job requirements. Job satisfaction and stress can affect mental health of midwives, and investigating the relationship between these variables can improve the quality of healthcare services. This study, therefore, was conducted to identify the relationship between OCB, occupational stress, and job satisfaction in Iranian midwives. Methods:This descriptive-correlational study was performed on 122 midwives working at healthcare centers of Mashhad, Iran, in 2014. The participants were chosen using a census approach. The tools for data collection included a demographic questionnaire, Podsakoff’s OCB Questionnaire, Minnesota Satisfaction Scale, and Karasek’s Job Content Questionnaire. Data analysis was carried out using Spearman and Pearson’s correlation, one-way ANOVA, and student t test were by SPSS version 20. Results: The mean age of the midwives was 38.46±7.22 years. OCB had a significant direct correlation with job satisfaction (r=0.223) and a significant negative correlation with job stress (r=-0.270)(

Designing a Strategy Map with Balanced Scorecard Approach (A Case Study in Montaserieh Hospital)

Background: A tool by which all individuals in an organization can understand the strategies of the organization in an overview is a strategy map. The purpose of this research is to formulate a strategy map in Montaserieh Hospital with a balanced scorecard approach. Methods: This is a qualitative and applied study that was conducted in Montaserieh Hospital of Mashhad in 2016. Initially, in group discussions with the analysis of the hospital's strategic plan: the Vision, strategy themes, and a list of goals related to the strategic plan were categorized into 4 perspectives of the balanced scorecard: financial, customer, internal processes, and learning and growth. By summarizing experts' opinions and various reviews, the way of achieving these specific goals and the relationship between goals in the perspectives were completed. Finally, about 22 different relationships were made which were related to the impact of perspective goals on each other and to reach the ultimate goals and vision. Therefore, the hospital strategy map was drawn up. Results: By reviewing the level of balanced scorecard perspectives and linking their goals, customers' perspective was at the highest level and, respectively, financial perspectives, processes, and growth and learning at the next levels. &quot;Empowering the required&quot; as the most basic goal and &quot;customer satisfaction&quot; was at the top of the strategy map. Conclusion: Investing in the field of growth and learning is very important since the employee ultimately affects the organization's outcomes and process and the goals of other perspectives and the vision of the hospital are realized by them. &nbsp

The Challenges of the Family Physician Program in the North East of Iran from the Perspective of Managers and Practitioners Working on the Plan

Background & Objective: In Iran, a new program called the Family Doctor was started in 1384. The present study aims to determine the challenges of the family physician system in Khorasan Razavi province. Materials & Methods: The present study is a quantitative-qualitative study. In this study, a sample-based sampling method was conducted with 11 managers and 9 family physicians working in the project in Khorasan Razavi. Then, based on the results of the interviews, a questionnaire was designed and confirmed by its validity and reliability in a descriptive-analytic study in 1395. The findings of the quantitative study were analyzed using descriptive statistics and Mann-Whitney, T-test and ANOVA tests at a significant level of 0.05 Results: In the analysis of qualitative content 9 basic concepts (comprehensive planning, health insurance system, compensation services, performance appraisal, facilities and welfare facilities, recruitment and maintenance of human resources, information system, culture and financing) were identified. The biggest challenge is in the area of compensation (4.55 ± 0.73) and the smallest in the area of facilities and facilities (3.67 ± 0.83). The greatest difference is between the viewpoints of managers and physicians in the field of facilities and amenities (0/61 ± 0/20) and the least in the field of culture (0.04 ± 0/17). Conclusion: The most common challenges faced by family physicians in the study are cultural, economic, environmental and working conditions. It is suggested that, in order to properly implement the plan of the family physician, it should be considered in coordination with the objectives of the plan at international level and the experiences of the countries that implemented the program

Assessment of Patient Safety Culture in a Selected Number of Pharmacies Affiliated to Mashhad University of Medical Sciences Using the Pharmacy Survey on Patient Safety Culture (SOPS)

Introduction: Patient safety culture plays a pivotal role in the improvement of patient safety level in health centers. This study aimed to assess patient safety culture in the pharmacies affiliated to Mashhad University of Medical Sciences, Iran using a standard questionnaire developed by the American Agency for Healthcare Research and Quality (AHRQ). Materials and Methods This analytic, descriptive, cross-sectional study was conducted on 108 pharmacists and pharmacy technicians in Mashhad, Iran in 2015. Participants were selected via random cluster sampling. Data were collected using the Pharmacy Survey on Patient Safety Culture (SOPS). Data analysis was performed in SPSS Version 16 at the significance level of 0.05. Results:Among various dimensions of patient safety culture, “communication openness” had the highest mean score (0.63±4.27) as obtained by the pharmacists, while pharmacy technicians had the highest mean score in the dimension of “teamwork” (0.58±4.18). Moreover, the lowest mean score was observed in the dimension of “overall perceptions of patient safety” in both sample groups. Conclusion: According to the results of this study, commitment of healthcare authorities to patient safety culture is the most important factor in the promotion of organizational patient safety. Considering that the lowest score of patient safety culture belonged to the dimension of “overall perceptions of patient safety”,it is recommended that related training interventions be implemented for healthcare staff in order to establish and promote the patient safety culture in pharmacies