Mashhad University of Medical SciencesJournal of Patient Safety & Quality Improvement2345-44825220170401Needlestick Injuries in Healthcare Workers in the North East of Iran509512854310.22038/psj.2017.20740.1148ENShapour Badiee AvalDepartment of Complementary and Chinese Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran0000-0003-4724-518XMaryam YaghoobiDepartment of Epidemiology, Faculty of Public Health, Iran University Of Medical Sciences, Tehran, IranMohammad Hasan EzzatiDeputy of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Maliheh ZiaeePsychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, IranReza VafaeenejadMashhad University of Medical Sciences, Mashhad, Iran.Gholamrezza BakhtiariDeputy of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Irandokht MostafaviDeputy of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Behnaz Samiee DalueeDeputy of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.0000-0003-1068-6950Journal Article20161214<strong>Introduction:</strong> Needle-stick injuries are the second most commonly reported adverse incident and constitute a major hazard for the transmission of blood transmitted diseases. The incidence of Needle stick is higher than the reported cases in different countries. Reporting of these exposures is often a challenge for HCWs (health care workers). This article describes the prevalence of occupational injuries caused by contacting patients with needle and sharp objects and fluids of the patients’ body fluids in HCWs. <br /> <strong>Materials and Methods:</strong> This cross-sectional study has been conducted in 4 hospitals affiliated to Mashhad University of medical sciences, Iran during 2008-2015. We assessed self-reported occupational exposures in HCWs includes nurse, physician, medical student and other.<br /> <strong>Results:</strong>Among the HCWs with NSIs, other personnel includes paramedics, assistants, crew, midwife, operation room personnel, and laboratory, radiology and physiotherapy personnel had the highest percentage of needle stick contact , followed by nurses. Self-reporting of needle-stick has been growing in this period. In this study, the hepatitis B immunity in sharps injury recipients was 90-95% in 2015. <br /> <strong>Conclusion: </strong>The prevalence of needle stick in HCWs is high. Preventive strategies had to be devised. Use of safety engineering devices, to encourage recording and reporting of incidents, hepatitis B immunity, serological tests, follow-up post exposure, training in precaution standard is necessary for HCWs and medical students.Mashhad University of Medical SciencesJournal of Patient Safety & Quality Improvement2345-44825220170401The Relationship between Organizational Justice and Organizational Citizenship Behavior among Nurses (Examining the Mediating Role of Organizational Commitment, Organizational Trust, and Job Satisfaction513520854410.22038/psj.2017.8544ENShadi MahmoudiIslamic Azad University, Sardasht, IranMohammad HassaniFaculty of Humanities, Urmia University, Urmia, IranSiamak AghlmandUrmia University of Medical Sciences, Urmia, Iran.Journal Article20161222<strong>Introduction:</strong> Justice has been recognized as the pivot of different organizational research, that the designation of the causal pattern involving the most important variables associated with it was the main objective of the present study.<br /> <strong>Materials and Methods:</strong> This was a descriptive-survey study. The statistical population consisted of all nurses of Imam Khomeini hospital in Urmia (n= 420), of which 201 nurses were selected by using Morgan’s table and by random sampling method. The instruments included questionnaires of organizational justice, organizational commitment, organizational trust, job satisfaction, and Organizational Citizenship Behavior whose reliability and validity were confirmed. The structural equations model method was used to analyze the data. <br /> <strong>Results:</strong>The results showed there was a positive and significant relationship between justice perception with organizational commitment, organizational trust, and job satisfaction. In addition, the mediating role of organizational commitment and trust was acknowledged in the relationship between justice and citizenship behavior in the model; however, the mediating role of satisfaction was not fitted in the relationship between justice and citizenship. <br /> <strong>Conclusion: </strong>According the research results that there was a positive and significant relationship between perception of justice with organizational commitment, organizational trust, and job satisfaction, paying attention to organizational justice for improving the staff’s organizational citizenship behavior is critical and indicates the distinct position of this variable in improving all attitudinal and behavioral variables and consequently in the hospital employees’ performance.Mashhad University of Medical SciencesJournal of Patient Safety & Quality Improvement2345-44825220170401The Comparison of Quality Of Life and Social Support among Fertile and Infertile Women521525854510.22038/psj.2017.12370.1111ENHamidreza JamilianDepartment of Psychiatry, Arak University of Medical Sciences, Arak, IranMehry JamilianDepartment of Obstetrics and Gynecology, Arak University of Medical Sciences, Arak, IranShirin SoltanyArak University of Medical Sciences, Arak, Iran.Journal Article20151124<strong>Introduction:</strong> Along with some authors through literature indicating the influence of infertility on the quality of life, this study aimed at comparing the impact of infertility on the quality of life and social support among fertile and infertile women.<br /> <strong>Materials and Methods:</strong> In this case-control study, 50 hospitalized and outpatient infertile women and 50 fertile women aged 20-40 referred to gynecology, obstetrics and infertility centers of Arak University of Medical Sciences from March 2013 to August 2013. The patients were requested to complete the Persian version of the WHOQOL-BREF (world health organization quality of life) and social support questionnaires. The demographic data and data extracted from questionnaires were collected and analyzed.<br /> <strong>Results:</strong>100 women (50 infertile and 50 fertile) with the average age of 33.70±6.53 were recruited. All patients were literate and had a high school diploma. To compare two groups regarding physical health, mental health, social relationship, quality of life, family support, friends’ support, support of other people and social support, we made use of one-way ANOVA. The score obtained from variables regarding infertile women was higher than that of fertile ones, and the difference between the two groups was significant. To compare environmental health, we used Kruskal-Wallis test. The mean score of environmental health among infertile women was higher than that of fertile women, however, the difference was not significant (P= 0.15).<br /> <strong>Conclusion: </strong>As indicated by the results, infertility reduces mental and physical health, social relationship and quality of life in women. Additionally, it was found that infertile women were less supported than fertile ones by society, family, friends and other people.Mashhad University of Medical SciencesJournal of Patient Safety & Quality Improvement2345-44825220170401Relationship between Irrational Beliefs and Marital Conflicts in Couples Based on Rational-Emotive Behavior Therapy526530854610.22038/psj.2017.8546ENAfarideh Tikdari NejadIslamic Azad University of Kerman, Kerman, IranNoshirvan Khezri MoghadamShahid Bahonar University of Kerman, Kerman, IranJournal Article20161224<strong>Introduction:</strong> The main aim of this study was to investigate the relationship between irrational beliefs and marital conflicts.
<strong>Materials and Methods:</strong> The research method was correlation and regression analysis. A total of 150 couples (150 females, 150 males) who were selected through available sampling method participated in this study. Participants were asked to complete the Golombok Rust Inventory of Marital State (GRIMS), and the Survey of Personal Beliefs (SPB). Comparative data analysis was performed using SPSS Version <sub>19</sub>.
<strong>Results:</strong>The result showed a significant positive association between irrational beliefs and its subscales awfulizin (r=0/157, p<0.01) self directed should (r=0/354, p<0.01) other directed should (r=0/196, p<0.01) self worth (r=0/116, p<0.05) (except for low frustration tolerance subscale(r=0/106) and marital conflicts. The results also revealed that self-directed shoulds significantly predicts marital problems.
<strong>Conclusion: </strong>In conclusion, the present study offers support for a relationship between the irrational beliefs postulated by Rational-Emotive Behavior therapy and marital conflict and indicates that couples with high irrational beliefs had a great number and frequency of conflicts and felt themselves more tense. Findings of this research can be used in marital consultation.Mashhad University of Medical SciencesJournal of Patient Safety & Quality Improvement2345-44825220170401Assessing Adherence to Protected Mealtime Guidelines in Iranian Hospitals531534854710.22038/psj.2017.16628.1136ENMehrane MehramizDepartment of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Tannaz Jami AlahmadiDepartment of Nutrition, School of Medicine, Mashhad University of Medical Sciences Mashhad, Iran.Mohsen NematySchool of Medicine، Mashhad University of Medical Sciences, Mashhad, Iran.Abdolreza NorouzyDepartment of Nutrition, School of Medicine, Mashhad University of Medical Sciences Mashhad, Iran.Journal Article20160517<strong>Introduction:</strong> Malnutrition is a prevalent problem in hospitalized patients, causing a wide range of negative clinical and economic challenges. Protected mealtimes (PM) aim to enhance the quality of mealtime experience, improve nutrient status in hospitalized patients, and limit all non-essential interruptions so that patients might eat in a clean, quiet, and safe environment.
<strong>Materials and Methods:</strong> This study is a clinical audit and was conducted in Mashhad teaching hospitals in order to evaluate mealtime interruptions that occurred among non-nutritional staff and influenced their food intake. Data were collected by direct observation. Lunchtime was chosen for audit because medical interruptions were more likely to happen during this meal. Two researchers (one dietitian, student and one dietetic assistant) observed lunch mealtime. The mealtime environment was monitored, and every negative interruption was registered. Exclusion criteria included patients who were nil-by-mouth or received enteral or parenteral nutrition.
<strong>Results:</strong>A total of 208 patients were involved in the audit. The recorded negative interruptions included medical round, educational round, nurses’ change-of-shift, and activities of environmental service workers. Among interruptions, both medical round and nurses’ change-of-shift were the most frequent. All mealtime interruptions summarized to medical round (2.5%) (including serum replace, drug injection, and IV replace), change-of-shift (2.5%), environmental-service-worker activities (2%), and educational round (2%).
<strong>Conclusion: </strong>Our study demonstrated that non-urgent interruptions during mealtimes were not adhered to PM guidelines, indicating the importance of addressing mealtime related issues in hospitals.
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Mashhad University of Medical SciencesJournal of Patient Safety & Quality Improvement2345-44825220170401Cross Sectional Study of Burn Infections and Antibiotic Susceptibility Pattern for the Improvement of Treatment Policy535541854910.22038/psj.2017.8549ENNeda PirbonyehBurn & Wound Healing Research Center, Microbiology Department, Shiraz University of Medical Sciences, Shiraz, Iran.Abdollah BazarganiBacteriology & Virology Department, Medical School, Shiraz University of Medical Sciences Shiraz, Iran.Amir EmamiBurn & Wound Healing Research Center, Microbiology Department, Shiraz University of Medical Sciences, Shiraz, Iran.Zahra AnvarInfertility Research Center, Shiraz University of Medical Sciences, Shiraz, IranSeied Mohsen HosseiniBacteriology & Virology Department, Medical School, Shiraz University of Medical Sciences Shiraz, Iran.Mitra ZardoshtBurn & Wound Healing Research Center, Microbiology Department, Shiraz University of Medical Sciences, Shiraz, Iran.Bahram DerakhshanBacteriology & Virology Department, Medical School, Shiraz University of Medical Sciences Shiraz, Iran.Journal Article20170224<strong>Introduction:</strong> Burn is a devastating form of trauma, and based on its condition, it could run the risk of infections. Infection of wound is a major cause of morbidity and mortality in burn cases. The current study investigates the prevalence of infectious agent in three years and antibiotic resistant pattern to improve and predispose a good policy of treatment in our environment.
<strong>Materials and Methods:</strong> In the present study, a total number of 3330 samples from 713 patients were evaluated for detection of the most prevalent infections and for finding out the antibiotic susceptibility pattern with routine microbiology procedures.
<strong>Results: </strong>Based on the results, 598 samples were reported positive. According to the results Pseudomonas aeruginosa, Coagulase Negative Staphylococcus and Acinetobacter sp. were the three most prevalent bacteria with a prevalence rate of 42.1%, 22.1% and 18.4% respectively. Furthermore, based on the results of distribution and diversity of bacterial infections, wound samples were the most infected samples with 73.6% of total infections. Finally, during these three years, there were no significant changes in the resistance pattern of Gram positive and Gram negative infectious agents.
<strong>Conclusion: </strong>By evaluating the infectious agents during the period of the study, it was found that due to the focus on treatment of Gram negative bacteria, Gram positive bacteria especially Staphylococcus aureus and Coagulase Negative Staphylococcus have at least doubled. This increase in two important nosocomial infections is a next threat of infection and septicemia for burn victims.Mashhad University of Medical SciencesJournal of Patient Safety & Quality Improvement2345-44825220170401Evaluation of the Influential Factors in Cancelling Surgical Operations and Developing Management Strategies to Reduce these Factors in Shahid Kamyab Hospital of Mashhad, Iran during 2012-2013542547909310.22038/psj.2017.9093ENAmir Ashkan NasiripourFaculty of Management and Economic, Islamic Azad University, Tehran, Iran.Mojtaba HosseiniFaculty of Management and Social Sciences, Islamic Azad University, Tehran, Iran.Alireza RezazadehSchool of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.Mohammad Ali AziziShahid Kamyab Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Journal Article20150707<strong>Introduction:</strong> One of the main determinants of hospital costs is the efficiency of operating rooms, and substantial resources are allocated to the management and timely performance of surgical operations. Cancelling surgical operations is one of the main causes of healthcare inefficiency and resources waste. The present study aimed to evaluate the rate and influential factors in cancelling surgical operations in Shahid Kamyab Hospital of Mashhad, Iran.
<strong>Materials and Methods:</strong> In this retrospective cross-sectional study, data were collected from the hospital information system of Shahid Kamyab Hospital and classified into five surgical services, including orthopedics, neurosurgery, general surgery, facial surgeries, and ear, nose, and throat (ENT) surgery. Causes of cancelling surgical operations were divided into six categories, including patient-related problems, surgeon-related problems, paraclinical test results, operating rooms problems, anesthesia, and hospital-related issues.
<strong>Results:</strong>Among 13,674 preplanned surgical operations, 8% were orthopedic surgical operations, 4.2% were ENT operations, 3.5% were facial surgeries, and 1.1% were neurosurgeries. The most frequent causes of surgery cancellation were due to clinical problems (2.21%), refusal of the patient to pay the costs (19.1%), and surgeon-related problems (11.4%), while paraclinical test results accounted for the lowest frequency in this regard (1.1%).
<strong>Conclusion: </strong>According to the results, most of the causes of surgery cancellation were patient-related. Therefore, it is suggested that patient evaluation be performed by surgeons and anesthesiologists prior to the surgical operation in order to prevent clinical problems during the surgery, offer insurance strategies, and solve the problems relating to the healthcare costs for the less privileged patients, especially those requiring surgery after accidents.Mashhad University of Medical SciencesJournal of Patient Safety & Quality Improvement2345-44825220170401Acute Febrile Encephalopathy in Adults; a Review of 3 Prospective Trials548552855010.22038/psj.2017.9176.1083ENSareh SajadiPatient Safety Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranHamidreza NaderiPatient Safety Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20150312<strong>Introduction:</strong> Acute Febrile Encephalopathy (AFE) is a heterogeneous clinical syndrome that refers to fever associated or followed by mental deterioration with or without other neurologic manifestations, including seizure and sensory motor deficits. The emergency nature of AFE necessitates high levels of knowledge and skill for the physician to provide correct diagnostic plan(s) among a wide range of etiologies. Fever accompanying shortens the list of differential diagnosis to mainly infectious agents.
<strong>Materials and Methods:</strong> Based on a digital search in Pubmed looking for the terms mental alteration, fever, adult, elderly and topical countries, and infectious diseases, three prospective trials which met the inclusive criteria were selected and reviewed.
<strong>Results:</strong>A total of 430 adult and elderly patients with a mean age of 30 years old admitted to different hospitals of India and diagnosed with AFE were investigated for the most common causes of AFE and other clinical outcomes. In this review, primary CNS infections including pyogenic meningitis (PM) and viral encephalitis various in the most common viral agent in different studies were the main causes responsible for AFE in adults, followed by sepsis associated encephalopathy (SAE) and cerebral malaria (CM). Poor prognostic and protective factors were listed based on the findings and by considering other studies. Viral encephalitis is associated with the most mortality rate and physical disabling, compared to other etiologies.
<strong>Conclusion: </strong>Primary CNS infections including bacterial meningitis and viral meningoencephalitis account for the most causes of AFE in adult and elderly patients with the most fatality for viral agents.
Mashhad University of Medical SciencesJournal of Patient Safety & Quality Improvement2345-44825220170401Evaluating the Effective Factors on Cancelling Surgical Operations in Shahid Kamyab Hospital of Mashhad, 2012-2013, and Developing Management Strategies to Reduce these Factors1909510.22038/psj.2017.11114.1101ENAmir Ashkan NasiripourFaculty of Management and Economic, Islamic Azad University Science and Research Branch, Tehran, Iran.Mojtaba HosseiniFaculty of Management and Social Sciences, Islamic Azad University North Tehran Branch, Tehran, Iran.Alireza RezazadehSchool of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.Mohammad Ali AziziShahid Kamyab Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Journal Article20150707Background: One of the main factors in determining hospital costs is the efficiency of operating rooms, and great resources are allocated to management and timely surgical operation. Cancelling surgical operations is one of the main causes leading to inefficiency and wasting the resources. This study is conducted to consider the rate and reasons of cancelling surgical operations in Mashhad Shahid Kamyab hospital.<br /><br />Material and Method: This study is a retrospective cross-sectional study. Here the data is collected from HIS software and is categorized under five surgical services: orthopedics, neurosurgery, general surgery, facial and ENT surgery.<br />Cancelling causes of surgical operations are divided into six types: patient-related problems, surgeon-related problems, paraclinical test results, operating rooms, anesthesia and hospital. <br />Result: In present study, of 13674 preplanned surgical operations, %8 was related to orthopedic surgical operations, %4.2 to ENT, %3.5 to facial surgeries and %1.1 to neurology, respectively.<br />The most frequent causes of surgery cancellation are clinical problems (%2.21), patient’s refusal to pay (%19.1), surgeon-related problems (%11.4) and the least common ones are related to paraclinical test results (%1.1).<br /><br />Conclusion: In this study, in regard that most causes of cancelling surgical operations are related to patient, it is suggested that patient evaluation be performed by surgeon and anesthesiologist before the operation, so that they can prevent clinical problems during operation, offer insurance strategies and solve problems relating to surgical costs of needy patients; especially accidental patients.