2024-03-28T15:36:41Z
https://ijhr.iums.ac.ir/?_action=export&rf=summon&issue=2003
2015-09-01
LBL_COMMENTED_AT
International Journal of Hospital Research
Int J Hosp Res
2251-8940
2251-8940
2015
4
3
Impact of Capacity of Mobile Units on Blood Supply Chain Performance: Results from a Robust Analysis
Abbas
Jokar
Seyyed-Mahdi
Hosseini-Motlagh
Background and Objectives: A sudden jump in blood demand during natural disasters may have strong negative impact on the performance of blood supply chain. Appropriate response to emergency situations requires predictive approach to determining the optimal allocation of blood supply chain resources for various disaster scenarios. The present study, thus, presents an optimization model aimed at decreasing blood shortage, blood wastage, and blood supply cost in emergency situations. Methods: This work is an extension of our previously introduced stochastic blood supply chain model, which was developed based on the Robust Optimization concept. The aim of this model is to determine the optimal number and service areas of the blood facilities under different disaster scenarios using mixed integer linear programming. While in our previous model, the capacity of blood facility center was assumed to be constant, in the present work, it is considered as an integer variable varying within a defined interval. The present model, hence, allows exploring the influence of capacity of temporary facilities on the total costs of blood supply chain. Findings: Changing the capacity of mobile units from 80 to 120 resulted in roughly 10% reduction in the costs, 20% reduction in the optimal number of fixed blood facilities, and 25% reduction in the optimal number of the required mobile blood facilities. Conclusions: While the results of model analysis predict a marginal impact of the capacity of mobile units on the total cost, the capacity of these units is anticipated to considerably influence the optimal number of both permanent and temporary facilities.
blood supply chain
robust optimization
Stochastic modeling
disaster
Emergency situations
2015
09
01
101
105
https://ijhr.iums.ac.ir/article_11685_e39bac588c03644bbcee23d9062e0861.pdf
2015-09-01
LBL_COMMENTED_AT
International Journal of Hospital Research
Int J Hosp Res
2251-8940
2251-8940
2015
4
3
Occupational Stress Suppress Production of Anti-HBsAg Antibody in Nurse Staffs Following Hepatitis B Vaccination
Mehdi
Abdolkarimi
Ali
Ravary
Ali
Khodadadizadeh
Fatameh
Askari
Somayeh
Pourtalebi
Mohammad
Kazemi Arababadi
Background and Objectives: Vaccination is the major strategy to protect nurses against infection with hepatitis B virus. However, some nurses do not produce sufficient amount of anti-HBsAg antibody required for immunity against infection. Chronic occupational stress has been proposed as a risk factor to humoral immunity. Given that nursing staff is exposed to occupational stress risk, this study was designed to investigate the potential impact of occupational stress on anti-HBsAg antibody titration. Methods: A total of 115 nurses who were fully vaccinated against hepatitis B in triplicate format and whose titers of anti- HBsAg antibody had been measured participated in the study. Titration data was derived from the laboratory archive or the HIS system. Occupational stresses and demographic characteristics were recorded using a validated job stress questionnaire. Data were summarized using descriptive statistical methods and analyzed using ANOVA and t-test. Findings: Nurses with higher occupational stress exhibited significantly lower anti-HBsAg antibody titration. No significant difference in the level of anti-HBsAg antibody titration was observed between the age, sex and BMI-score groups. Conclusions: Based on our results, occupational stress may be an important risk factor to the effectiveness of vaccination against hepatitis B. This implies that stressed nurses are at risk of viral infection. Our study, hence, recommends urgent investigation of this hypothesis at larger scales, and if validated, taking appropriate measures to protect nurses from infection.
Psychometrics
Patient Satisfaction
Outpatients
Reliability and validity
Factor analysis
quality improvement
Scale development
2015
09
01
107
111
https://ijhr.iums.ac.ir/article_11686_12a82e08cb074f89d5583f0df4601617.pdf
2015-09-01
LBL_COMMENTED_AT
International Journal of Hospital Research
Int J Hosp Res
2251-8940
2251-8940
2015
4
3
Hospital Bed Utilization: Perceptions of Healthcare Practitioners from Northern India
Vikrant
Kanwar
Anil Kumar
Gupta
Sonu
Goel
Pramod Kumar
Gupta
Background and Objectives: Hospital bed utilization is influenced by various factors, which may be categorized into patient-related, physician-related, and administration-related issues. It could be argued that the causes of inappropriate hospital bed utilization would be perceived differently by the clinicians and the patients. Given the unique role of clinical practitioners in quality of care, their views on the causes of inefficient hospital resources use should be referred to in any improvement initiative. The aim of this study, thus, was to survey the relative importance of factors influencing utilization of hospital beds as perceived by the resident doctors and nurses. Methods: This cross sectional study was conducted in an Apex Tertiary Care Public Institution in northern India. All the resident doctors and nurses from 18 wards of 7 specialties and 7 super-specialties were interviewed using a structured validated self-administered questionnaire. The data were summarized by descriptive statistical methods and analyzed using ANOVA and Chi-square tests. Findings: While a substantial percentage of clinicians perceived that hospital beds were inappropriately utilized, the resident doctors were more convinced of inefficient hospital bed utilization than the nurses. High expertise of the doctors, reputation of the Institution, and limited autonomy of the residents were perceived as the causes for overstay. In addition, the resident doctors considered lack of training, unclear job description, and long duty hours as the reasons for inappropriate bed utilization, while their nursing counterparts did not opine such. Most doctors agreed that lack of appropriate policy for and lengthy procedures of admission and discharge influence the hospital stay, whereas corresponding emphasis was not recorded from the nurses. Also congruent with some previous studies, the majority of the nurses and doctors perceived ineffective hospital information system, absence of standard operating procedures, and lack of quality assurance system in ward management as potential contributing factors to overutilization of hospital resources. Conclusions: While nurses highlighted administrative factors as the major causes of overstay, the resident doctors perceived all examined factors, including patient-related, physician-related, and administrative factors to be important; though in agreement with their nursing counterparts, they gave a higher weight to the administrative issues. The information provided on the relative importance of factors contributing to patient overstay may help policy-makers and administrators to promote more efficient utilization of healthcare system resources. According to our results, implementation of quality assurance system in ward management, revising admission and discharge policy, improving hospital information system, use of modern technology, providing clear-cut job description, and providing the clinicians with appropriate training may help alleviate the patient overstay and suboptimal utilization of resources in hospital.
Hospital bed utilization
Patient overstay
Hospital management
2015
09
01
113
118
https://ijhr.iums.ac.ir/article_11687_8d43bc2b6eef468da8ce2199a3b07713.pdf
2015-09-01
LBL_COMMENTED_AT
International Journal of Hospital Research
Int J Hosp Res
2251-8940
2251-8940
2015
4
3
Magnetic Resonance Imaging of Central Nervous System and Paranasal Sinuses in Multiple Sclerosis Patients: Findings from a Survey of Clinical Records in Kermanshah Province
Fatemeh
Amiri
Maryam
Pourkaveh
Abbas
Haghparast
Amir Hossein
Hashemian
Background and Objectives: Multiple sclerosis (MS) is the most common demyelinating disease of the central nervous system with more than 5.2 million people across the world being afflicted with. Magnetic Resonance Imaging (MRI) is a valuable tool in the diagnosis of MS. This study surveys the results of MRI of the central nervous system and paranasal sinuses in the sample of MS patients in Kermanshah Province, Iran. Methods: The clinical records of a total of 294 patients admitted to the Neurology Ward of Farabi Hospital of Kermanshah City (Western Iran) between 2004 and 2014 and diagnosed to be afflicted with MS were surveyed. The data were collected using a checklist prepared based on the McDonald Wibers standard criteria. The checklist consisted of 37 items, related to the MRI data of the CNS and paranasal sinuses of MS patients. The data were collected in four domains, including the most common early clinical signs of the patient, distribution of lesions, affliction with sinusitis, and demographic characteristics. The collected data were summarized using descriptive statistical methods. Findings: MRI identified MS plaques in 94.90% of the patients. Female, Married, housekeeping, and undergraduate patients and the patients with 21-40 years of age had the highest frequency among the MS patients (59.5%, 50.2%, 70.6%, 42%, and 72%). Hands and feet anaesthesis was the most frequently seen early signs (63.80%), followed by visual impairment (42.3%) and ataxia (12.6%). The most frequently involved anatomic site was the white matter surrounding the ventricles (77.50%), followed by centrum semiovale (75.4%), and corpus callosum (17.1%). We also found that 16% of the patients afflicted with MS had sinusitis, with the most frequent anatomical sites afflicted in them being sphenoid sinuses (63.8%). Conclusions: Our study provided further evidence that the MRI is an accurate and reliable method for diagnosing MS. No gross differences in the frequency of MS disease among age, sex, and lesion pattern groups compared to other studies were identified. Observing sinusitis in patients afflicted with MS is suggestive of their random association.
Multiple Sclerosis (MS)
Paranasal sinuses
Magnetic resonance imaging (MRI)
Central nervous system (CNS)
2015
09
01
119
122
https://ijhr.iums.ac.ir/article_11688_5f4d541c60e9f988296a6e7ba6489a6d.pdf
2015-09-01
LBL_COMMENTED_AT
International Journal of Hospital Research
Int J Hosp Res
2251-8940
2251-8940
2015
4
3
State and Trait Anxiety in Patients Undergoing Coronary Angiography
Tayebeh
Moradi
Mohsen
Adib Hajbaghery
Background and Objectives: Studies have shown that patients awaiting coronary angiography (CA) are often anxious. High level of anxiety can lead to physical and psychological stress with adverse effects on organs, especially heart. There is limited information on state and trait anxiety level in these patients in the literature. This study was thus designed to investigate the level of these two types of anxiety in patients undergoing CA. Methods: A cross-sectional study was conducted by enrolling 50 patients. A demographic questionnaire and Spielberger State and Trait Anxiety Inventory were used for data collection. T-test was used to compare the anxiety level between gender and age groups. Findings: The baseline state and trait anxiety mean levels in the CA patients were low (34.36 ± 5.56, 35.9 8 ± 7.49, respectively). The highest level of both state and trait anxieties was observed 30 min before CA (41.44 ± 8.45 and 37.84 ± 6.88, respectively), and it was significantly higher than the corresponding value at baseline state as well as the anxiety after CA (P < 0.05). Female patients were significantly more anxious than male patients both before and after CA (P < 0.05). Conclusions: The state and trait anxiety of CA patents reaches to a relatively high level immediately before angiography. Given the adverse effects of anxiety on the patients’ health, it is crucial to take measures to get the patients relaxed before CA. Evidence-based designing of nursing interventions, training the nurses on this issue, and providing patients with information on the nature of the CA practice may be effective. Females should be more focused in the relevant interventions.
Coronary Angiography
Patient care
State anxiety
Trait anxiety
Adverse effect
2015
09
01
123
128
https://ijhr.iums.ac.ir/article_11690_a3d75bdb5b8c8e1c4dbd0859c775a172.pdf
2015-09-01
LBL_COMMENTED_AT
International Journal of Hospital Research
Int J Hosp Res
2251-8940
2251-8940
2015
4
3
The Impact of Organizational Factors on the Effectiveness of Knowledge Management among Nurses
Sayyed Ali
Koushazade
Setareh
Omidianpoor
Meisam
Zohurian
Background and Objectives: Knowledge Management (KM) has emerged as a pathway towards competitive advantage in current complex industrial environment. The aim of the present study was to explore the relationship between KM effectiveness and various organizational factors including social interactions (trust, communication and coordination), infrastructure factors (structure, information technology, and organizational culture), and process factors (knowledge acquisition, conversion, application and protection) in nursing staff. Methods: A sample of 220 nurses was surveyed out of the total of 392 nursing staff at Golestan Hospital of Ahvaz City (South Western Iran). KM effectiveness questionnaire (Lin, 2008), social interactions questionnaire (Huang and Li, 2009), and infra-structure and process questionnaire (Ghosh and Scott, 2006) were used as the study tools. The data were analyzed by structural equation modeling (SEM) and partial least squares (PLS) methods. Findings: The results showed that social interactions, infrastructural factors, and process factors are significant predictors of the effectiveness of KM among nurses at both individual and organizational levels. Conclusions: Among other organizational factors, infrastructure factors have the strongest positive influence on KM. This implies that KM practices need to focus on promoting structure, information technology and culture to foster a knowledge-friendly environment for nurses.
Knowledge management effectiveness
Infrastructure capabilities
Process capabilities
Social Interactions
Nurse
Health care organization
2015
09
01
129
135
https://ijhr.iums.ac.ir/article_11692_896335d9f43693310b09497f4bbad5d5.pdf
2015-09-01
LBL_COMMENTED_AT
International Journal of Hospital Research
Int J Hosp Res
2251-8940
2251-8940
2015
4
3
Hospital Income Loss due to Incomplete Clinical Documentation: A Survey of Service Items and Potential Causes in the Iranian Teaching Hospitals
Masoud
Yavari
Leila
Azimi
Ghassem
Khosro Abadi
Mahnaz
Baladast
Sharareh
Salaj Mahmoudi
Sheida
Vahidi
Background and Objectives: Many Iranian public hospitals are faced with serious financial challenges such as shortage of income and heavy debts. Nevertheless, many of the healthcare services are often remained unearned for not being included in the clinical records or patient bill, resulting in considerable loss of legitimate hospital income. Given the limited studies in this area in Iran, the present study aimed to survey the undocumented healthcare services which are potentially income-generating, and the factors contributing to the deficient documentation. Methods: A cross-sectional retrospective study was conducted. A sample of 400 clinical records was selected from six hospitals affiliated with Shahid Beheshti University of Medical Sciences in proportion to the number of hospital beds and the rate of discharges. A checklist was developed to record the delivered healthcare services, which were incompletely documented or neglected in the patients’ bills. Using a researcher-made questionnaire, we also asked the opinions of financial managers, the income managers, the chief operators, and other personnel of the discharge unit, with regards to the human resources factors influencing clinical documentation and accounting. The tariffs for the health services were calculated based on the corresponding K value, extracted from the California Book of relative values of diagnostic and therapeutic services. Data were summarized and analyzed using descriptive statistical methods. Findings: NG tube insertion; CVP insertion, lumbar puncture, pleural tap and cut down were the five most frequently neglected medical services in the clinical records. Overall, 998 services for the amount of 75 million Rls were not documented. Only a minority of the personnel of the finance departments had a background of education in accounting. In addition, the majority of financial department personnel had not attended any training course related to the documentation of healthcare services and discharge process. On average, 20 medical records are examined on a daily basis by a single operator in the pre-discharge stage, ranging from 13 to 25 records. In addition, the employees of the discharge units were found to have the dual task of examining clinical records and discharging the patients. Conclusions: Our study identified a number of potentially income-generating healthcare services that are often left unearned in Iranian hospitals. Identification of these services may help prevention of the associated income loss in future. We also identified a number of factors that may contribute to inaccurate documentation of healthcare services. The importance of issue and the possible existence of other factors contributing to incomplete clinical documentation and hospital income loss recommend further large-scale studies.
Healthcare services documentation
Inpatient
Hospital
2015
09
01
137
141
https://ijhr.iums.ac.ir/article_15468_1b4489ab6b96d2bc8240b085fb1aec14.pdf
2015-09-01
LBL_COMMENTED_AT
International Journal of Hospital Research
Int J Hosp Res
2251-8940
2251-8940
2015
4
3
Quality of Hospital Bed Performance Studies based on Pabon Lasso Model
Afsoon
Aeenparast
Faranak
Farzadi
Farzaneh
Maftoon
Hamed
Zandian
Mehdi
Rezaei Yazdeli
Hospitals’ bed productivity has a remarkable effect on health system performance. The Pabon Lasso Model (PLM) is a useful tool for evaluation of inpatient beds performance and there is a growing trend in use of this technique in hospital performance evaluation. The aim of this study is to review the literature on PLM to gain insight into quality the results of these studies. By adopting a systematic review style, the full text of a total of 29 documents on the topic was reviewed. While in 81.3% (n=26) of the documents Pabon Lasso diagram has been represented complete and correctly, the results of a large fraction of the reviewed studies (59.6%) was limited to identifying the status of the hospitals in question the Pabon Lasso chart, without further analysis of the chart in the context of hospital resources. Our study hence recommends that future studies can draw further useful implications from the PLM model by focusing more on the interpretation of the results in the practical context of hospital management.
2015
09
01
143
148
https://ijhr.iums.ac.ir/article_15469_bb73ce49e649e7ad9595d79a1f305d6d.pdf