Barriers to Knowledge Sharing among Nurses in Educational Hospitals of Kerman City, Iran

Introduction: Considering the importance of knowledge sharing in recent years and the nurses' need to act based on research in order to use their findings, experiences, and information for conscious decision making in clinical practices and in interaction with others, this study aimed to identify barriers to knowledge sharing among nurses in order to examine the challenges facing it. Method: This qualitative study was conducted using semi-structured interviews with 21 nurses in educational hospitals of Kerman City, Iran. All the interviews were recorded and then transcribed line by line and finally analyzed using Colaizzi method. Results: The barriers were identified in six main categories including "culture", "financial facilities", "politics, rules and regulations", "communications", "human resources", and "management process". Conclusion: Effective knowledge sharing among nurses with the aim of increasing knowledge level and enhancing their services in the hospitals is essential. In addition, it is necessary to use strategies to face challenges and this requires management and policymaking more than before. Keywords: Knowledge management, Nurses, Barriers, Educational hospitals, Ira

Causes of Surgery Cancellation in Iran: A Systematic Review

Background: Cancellation of surgical procedures is one of the biggest challenges in hospitals throughout the world and it is important as it increases patients' stress, expenses and wastage of time, and prolongs the duration of hospitalization of patients. The aim of this study was to review literature related to reasons of surgery cancellation in Iran. Methods: This systematic review was conducted from March to Sep. 2014. The keywords including cancellation, delay, postpone, cancelled surgery, surgery operation and Iran were searched in international search engines including Pubmed, Scopus, ProQust and Google scholar and Persian indexing websites of SID, Magiran and Iranmedex. All articles related to cancelled operations in Iran, written in English or Persian (from Jan 1, 2004 until Sep 31, 2014) were collected. Then, those articles which contained any of the selected keywords in their titles or abstracts were compiled, and others were excluded. At last, a check list including title of article, time and location of study, sample size and location and cancellation cause was designed for final assessment. Results: A total of 646 records were found in 7 selected databases of which 13 articles met the criteria for inclusion in this study. The main cases of surgery cancellation were related to operating room and hospital, anesthesia, patient's non-clinical problems, the surgeon and clinical problems. Conclusions: Adoption of strategies for on-time initiation of surgical procedures, identification of patients' underlying problems and the appropriate process of hospital admission can be effective in reducing the rate of cancelled operations

Evaluation of the Task Compliance of Medical Education Development Centers from the Viewpoint of the Managers of the Centers

Background: Medical education development (MED) centers are established in order to improve the quality of medical education. It seems that after more than two decades since the establishment, the centers still have difficulties to perform some tasks. Objectives: According to the important role of MED centers, the current study aimed at adapting the performances of such centers with their assigned tasks. Methods: The current qualitative applied study was conducted in 2013. The statistical population of the study included managers of MED centers in Iran. Data were collected through a questionnaire containing open questions. During a national meeting the questionnaire distributed among 40 managers of MED centers and then analyzed using content analysis. Results: More than half of the major functions that the managers stated, were referred to the first, second, and fourth tasks of the centers, and only 18% of the major functions were related to other tasks (11 cases). About 28% of the functions performed in such centers had no direct correlation with any of the 14 tasks. Conclusions: Despite the history of MED centers for several decades, they are not justified in respect to their duties. It is recommended that guidelines be developed to address all duties and adequately monitor their implementation. Keywords Medical Education Development Centers Performance Indicator Quality Medical Education Ira

Implementing Quaternary Prevention Using the Rural Family Physician Program in Iran: Grounded Theory

Background: The present study investigated the possibility of implementing quaternary prevention using family physicians in Iran’s health system.Methods: The present study was a qualitative study conducted with a grounded theory approach. Thirty-four participants, who were faculty members and experts, were selected by purposive and theoretical sampling using the snowball approach until data saturation. The data were collected through semi-structured interviews. The interviews took 20 to 60 minutes each, based on the circumstances and the participant’s willingness to continue. Data analysis was performed along with data collection by Strauss and Corbin’s constant comparative analysis. Using Lincoln and Guba criteria, the accuracy and strength of this research were confirmed.Results: The dimensions model of quaternary prevention using family physicians in Iran were specified in six axial categories: causal conditions, contextual conditions, intervening conditions, strategies, and outcomes. The phenomenon was the promotion of quaternary prevention, including defining quaternary prevention, family physicians, the philosophy of quaternary prevention, and the philosophy of family physicians—social, political, economic, cultural, and technological conditions as contextual and intervening conditions. Causal conditions were doctors, patients, and the health system. Two main strategies were intersectoral administration and intra-sectoral governance. Outcomes included efficiency and the provision of security for society.Conclusion: For quaternary prevention promotion and to offer ethically and rationally acceptable scientific services to the people, it is necessary to promote the position of the family physician as the primary implementer of quaternary prevention in healthcare. Getting to the PHC umbrella is achieved through intra-sectoral leadership and inter-sectoral governance, which supports the patient and reduces unnecessary care

An Investigation of Prescription Indicators and Trends Among General Practitioners and Specialists From 2005 to 2015 in Kerman, Iran

Abstract Background: The World Health Organization (WHO) aims to promote strategies that ensure efficacy, safety, suitability, and cost-effectiveness of medicine prescription. Health systems should design effective mechanisms to monitor prescription and rational use of medicines at all healthcare settings. This study aimed to determine and analyze prescription patterns of general practitioners and specialists in Kerman/Iran from 2005 to 2015. Methods: This is an explanatory mixed method study. Data were gathered during two phases. At the first phase, prescriptions issued by physicians during 2005-2015 were reviewed to extract information required to develop eight main prescription indicators. In the second phase, the indicators trends were presented to experts participating in expert panel to have their opinions and analyses on the data obtained in the first phase. Experts were selected based on their experience and expertise in medicine and/or health policy and/or experience in implementation of polices to promote rational use of medicines. Some experts attending the panel were a sample of physicians whose prescriptions were included in the first phase. Results: Findings revealed that two indicators of the average price of prescriptions and the maximum number of medicines in each prescription had an increasing trend over the study period. Reasons including unprecedented devaluation of the Iranian Rial and willingness of young physicians to prescribe more medications were proposed as the primary contributors to the observed increasing trends. However, other indicators including types of prescribed medicines, average number of medicines per prescription, the percentage of prescriptions with more than four medications, a percentage of encounters with a corticosteroid prescribed, a percentage of encounters with an antibiotic prescribed, and a percentage of encounters with an injection prescribed decreased in the study period. Reasons of controlling initiatives adopted by the Ministry of Health, the higher responsibility of physicians, adoption of continued medical education (CME) programs, and improved knowledge of pharmacists, physicians, and patients about irrational use of medicines were proposed by participants as the main reasons for the decreasing trend. Conclusion: Findings indicated that prescription indicators were better in Kerman than those of country average over the study period based on comparing the results of this study and others in Iran. However, they were non-desirable when compared to the international average. The number of factors contributes to the irrational use of medicines, including lack of knowledge among healthcare providers and patients, patients’ misunderstanding about the efficacy of some particular medicines, the high cost of drug development and manufacturing, and unavailability of effective medicines

Does a socially well integrated university have anything to do with faculty retention? A study on Kerman University of Medical Sciences-2011

Purpose – The purpose of this paper is to measure the relationship between organizational social capital and retention of faculty members in Kerman University of Medical Sciences in 2011. Design/methodology/approach – Using a stratified multistage sampling, 120 faculty members were recruited to fill the questionnaire. Findings – There were a direct and positive bilateral (r¼0.65) relationship between social capital and retention of faculty members. Originality/value – The university officials and policy makers need to pay closer attention to some issues such as providing welfare facilities, salary and wages, benefits, interests and appreciation for faculty members. Keywords Socia

Mammography in Rural Areas of Iran: A Qualitative Study for Designing a Social Marketing Intervention

Introduction: Breast cancer is the most common cancer leading to death in women. So, early detection and treatment of it is very important and increase the patient survival. Mammography is one of the most effective methods for diagnosis of the breast cancer. We aimed to study for designing a social marketing intervention in rural areas of Bojnourd, Iran to propagate using mammography among women. Method: In this qualitative study, 46 women in four focus group discussions (FGD) discussed their views and ideas about mammography. All discussions were voice-recorded and written by two note takers. Using ATLAS.ti5.2 software, the collected data were analyzed. Results: Five main themes including mammography in general, barriers to doing mammography, appropriate communication methods and channels and opinion leaders for them to do this exam, were extracted. Conclusion: Designing a social marketing-based intervention can be useful for propagation of using mammography among women. Keywords: Breast cancer, Mammography, Qualitative study, Social marketing, Rural wome

The Projection of Burden of Disease in Islamic Republic of Iran to 2025

Objective: Iran as a developing country is in the transition phase, which might have a big impact on the Burden of Disease and Injury (BOD). This study aims to estimate Burden of Disease and Injury (BOD) in Iran up to 2025 due to four broad cause groups using Disability-Adjusted Life Year (DALY). Methods: The impacts of demographic and epidemiological changes on BOD (DemBOD and EpiBOD) were assessed separately. We estimated DemBOD in nine scenarios, using different projections for life expectancy and total fertility rate. EpiBOD was modeled in two scenarios as a proportion of DemBOD, based on the extracted parameters from an international study. Findings: The BOD is projected to increase from 14.3 million in 2003 to 19.4 million in 2025 (95% uncertainty interval: 16.8, 21.9), which shows an overall increase of 35.3%. Non-communicable diseases (12.7 million DALY, 66.0%), injuries (4.6 million DALY, 24.0%), and communicable diseases, except HIV/AIDS (1.8 million DALY, 9%) will be the leading causes of losing healthy life. Under the most likely scenario, the maximum increase in disease burden due to DemBOD is projected to be observed in HIV/AIDS and Non-communicable diseases (63.9 and 62.4%, respectively) and due to EpiBOD in HIV/AIDS (319.5%). Conclusion: It seems that in the following decades, BOD will have a sharp increase in Iran, mainly due to DemBOD. It seems that communicable diseases (except HIV/AIDS) will have less contribution, and especially non-communicable diseases will play a more significant role

Does a socially well integrated university have anything to do with faculty retention? A study on Kerman University of Medical Sciences-2011

Purpose – The purpose of this paper is to measure the relationship between organizational social capital and retention of faculty members in Kerman University of Medical Sciences in 2011. Design/methodology/approach – Using a stratified multistage sampling, 120 faculty members were recruited to fill the questionnaire. Findings – There were a direct and positive bilateral (r¼0.65) relationship between social capital and retention of faculty members. Originality/value – The university officials and policy makers need to pay closer attention to some issues such as providing welfare facilities, salary and wages, benefits, interests and appreciation for faculty members