Developing the use of quality indicators in sterilization practices

Health-care-associated infections are a major threat to the safety of patient care. Control of such problem is a major criterion for hospital accreditation. This study was aimed to determine the developing use of chemical [class 6 products] and biological indicators in Tabriz district hospitals since 1997 to 2011. We conducted this time-trend interventional study with all of the public and private hospitals, which counted to 21 in Tabriz district as a sample. The situations of indicator use were presented for each time in the base of indicator groups. Furthermore, the results were showed in the base of hospital groups. All of district hospital [n=21] with 74 autoclave machine and 22 central sterilization room were studied. The result of second time study in 2008 showed a markedly improvement in the control of sterilization processes. Furthermore, we continued our intervention results 6 month later in 2009 and 2 years later in 2011. The most striking result were use of chemical indicator in 100% of hospitals. However, there are defects in the use of biological indicators [63.65%]. The most obvious finding was significant improvement in sterilization control especially in development the use of chemical indicators. The finding of this study has a number of important implications for hospital managers and infection control practitioners such as continuous practical training of CSSD personnel in hospitals and mandating of indicator using in all sterilization process with controlling of this subject in evaluation and accreditation of hospital programs

[Preventing nosocomial infection transmit in gynecology and midwifery service providers in Tabriz [experience of educational interventions]]

Ignorance in infection control precautions and great number of women's seeking health services necessitate conducting of effective educational interventions in order to improving performance of outpatient units in prevention of transmission of infectious agents. This study compared two educational methods, including seminar with printed materials and printed materials only. In this interventional study, gynecologists and midwives of both public and private sections were studied. Data were gathered by questionnaire, checklist and microbiologic studies. After primary data gathering, methods of seminar with printed materials and printed materials only were performed in 81 and 67 subjects, respectively. After three months, results were compared with primary data. Regular controlling of dry heat or autoclave by medical engineers, using disposable speculum, proper disinfectant solution and reducing the number of positive microbial samples were highly influenced by printed materials method. While, in meeting standard time and temperate limit of sterilization and using proper disinfectant solution, the first method had better influence. In the most items, printed materials had higher result compared with participate in seminar and receiving printed materials. Performance indicator increased from 65% to 78% in first method and 80% in second method [p < 0.001]. Our findings are compatible with recent studies published in Iran and other countries. It showed the less effect of traditional presentations alone and high effects of audit and feedback on professional practice and health care outcomes. Therefore policy making on effective medical education and audit and feedback for infection prevention is recommended

Effectiveness of child health services in Iran Health System [East Azarbayjan and Zanjan Proviances]

In order to achieve the objectives of MDGs especially reduction of child mortality, the effectiveness of services must be increased. The main objective of the present study is surveying the effectiveness of child health services in Iran Health System. This cross sectional study was performed based on existing data. We compared data of 1500 children with their sibling. The weight and height of second children were increased as compared to first children. Performance of health care personnel was also improved in growth chart drawing, promoting breast feeding, and on time complementary feeding. Health network performance showed promotion, however, monitoring and assessing guidelines must be changed

Decentralization in function of stewardship of health systems in different countries and propose appropriate model for Iran

The health system of Iran similar to other countries; faces variety of challenges and problems due to the issues of equity, quality, relevancy and effectiveness. In order to respond effectively to these fundamental issues, as sustainable, planed and purposeful reform is necessary. In the latest decade, health sector decentralization polices have been implemented on a broad scale throughout world especially in developing countries. Decentralization actually involves the transfer of variety of service provision mechanisms from central authority namely Ministry of Health [MOH] to preferable units or alternate institutions. Function of stewardship has a fundamental role in performance of health system. In the descriptive and comparative present research mechanisms of decentralization in England, Turkey, Zambia, Ghana, Mexico, Thailand, France, Chile, Sweden and Philippines has been reviewed in order to suggest an appropriate Model for Iran. A model of stewardship function for Iran was reviewed by 65 experts including health management professors, head of medical universities and ministries of MOH and vice chancellors of them with Delphi techniques. Obtained results from the analysis of 35 collected questioners indicated that all participated subject agreed with appropriate these developed model. Statically the module was also confirmed the significant of results [a=0.05 Z=3.14]. It was concluded that: Developing and situating policymaking agency at MOH, situating and participating health councils in management of health. Managing hospitals through board of trusts with enough autonomy. Organizing the health enterprise [HE] and managing hospitals in the form of cluster. Organizing and situating national committes of decentralization and accreditation. Starting the decentralization process in the three next years