[Patient safety climate in medical centers of Kashan]

Introduction: The issue of patient safety is today of much importance for the medical community and the World Health Organization in the developing and developed countries. Medical errors are serious threats to the public health and patient safety. The aim of this study was to determine nursing staff's viewpoints about patient safety climate in medical centers of Kashan

Methods and Materials: In this descriptive study 218 nurses working in the medical centers of Kashan were participated. Data were collected by questionnaire included two parts, demographic and 'Safety Climate Questionnaire Patient' with seven dimensions that covered by the questionnaire were: educational opportunities, reporting, refreshment, head nurses' viewpoints, nursing condition, relation with physician, and nurses' inter-relations. Content validity method and Cronbach's alpha coefficient [0.89] were used for confirming validity and reliability of the questionnaire, respectively. Data were evaluated using the SPSS [v.11]

Findings: The results showed that mean age of the nurses participated in the study was 32.63 +/- 6.85 years, of them 85.8% were female. The mean of patient safety climate score in all seven aspects were significantly different. Except for the refreshment aspect, other aspects had different mean scores in different centers [p=0.001]. Highest and lowest mean scores were related to the nurses' inter-relations [3.24 +/- 0.67] and head nurses' attitudes [2.47 +/- 0.71], respectively

Conclusion: Patient safety climate in the centers under the current study was not in a good condition. This does motivate the managers of the health sector in the city to adopt an appropriate approach to patient safety climate in health care centers

[ quality of hospital services in Kashan educational hospitals during 2008-9: the patients' viewpoint]

The main mission of any hospital in a health care system is to promote care quality for patients and to meet their needs and expectations. The aim of this study was to evaluate the quality of hospital services from the viewpoint of patients admitted to Kashan educational hospitals. In this cross-sectional study, 390 patients admitted to Kashan educational hospitals were selected based on the stratified sampling and their points of view were evaluated using SERVQUAL questionnaire during 2008-9. The quality attributes of the questionnaire consisted of seven dimensions [e.g. physician's empathy, physician's availability, the reliability of physician performance, nurse's responsibility, nurse's empathy, drugs management and tangibility of services]. Validity and reliability of the questionnaire were confirmed using content validity and Cronbach's alpha coefficient [0.93], respectively. The data were analyzed using the Kruskal-Wallis and Mann-Whitney tests. The mean age of the respondents was 45.72 +/- 18.36 years and 54.1% of subjects were men. There was a significant difference among the mean of seven dimension scores and the total quality dimension. Moreover, a significant difference was observed in the quality score mean of different dimensions among hospitals. The highest and lowest means of quality score were for physician's empathy [3.97 +/- 0.75] and tangibility of the services [3.76 +/- 0.58], respectively. From the patients' viewpoint, educational hospitals have made good progress in providing hospital services; however, different quality scores among quality dimensions in any hospital signify that the health care administrators should pay more attention on the quality improvement programs to improve patients' satisfaction

Job satisfaction among community health workers in Zahedan District, Islamic Republic of Iran

We conducted a cross-sectional survey among 74 community health workers in rural health houses to investigate overall job satisfaction and satisfaction with 8 aspects of the job [work itself, co-workers, management, workload, promotion, organizational structure, working conditions, and payment and benefits]. Data were collected by a self-administered questionnaire based on the Job Descriptive Index and the Employee Satisfaction Inventory. Overall job satisfaction of respondents was moderate. They were satisfied with the work itself and co-workers, but very dissatisfied with all other aspects, especially payments and benefits. Providing opportunities for promotion and improving payments and work conditions would increase overall job satisfaction and promote quality of care

[Quality gap in primary healthcare services in Bandar Abbas: women's perspective]

The Service quality gap is the gap between customer expectations and the perceived quality of the service delivered. The basic step in eliminating this gap is recognizing customers' perceptions and expectations of service quality and determining the quality gap. The aim of this study was to determine the quality gap in primary healthcare services in the health centers of Bandar Abbas. This was a cross-sectional study and the target population consisted of women attending the health care centers of Bandar Abbas. We selected a total of 400 women according to the order of their attendance. The SERVQUAL measurement instrument was used to determine the gap in service quality. The instrument comprises five dimensions: tangibles, reliability, responsiveness, assurance and empathy. Data were analyzed by the SPSS software. There were quality gaps in all the five dimensions of service quality. The smallest gap [-0.76] was in the assurance and the greatest gap was observed for the empathy [-0.98]. There were significant differences between the mean of service quality gap in all dimensions [P<0.0001]. The negative gap in service quality indicates that client expectations are higher than their perceptions. Thus, there is a need for improvement across all the five dimensions

[ comparative study on the importance of dimensions of educational services at Zahedan university of medical sciences: faculties and students' viewpoints]

There are differences between the recognition of service providers about the importance of dimensions of services, and its real importance as viewed by service receivers. This leads to planning and decision making on quality promotion in which the views of providers are more effective than those of the customers. In such circumstances, the quality of services is reduced in the customer's viewpoint. This research aims to compare the importance of dimensions of educational service in the faculty members, and the student's viewpoints. This cross-sectional descriptive research was performed in 2004 in Zahedan University of Medical Sciences. All the faculty members and 386 students were chosen as the research subjects. A questionnaire was used for data collection. For statistic analysis' descriptive and analytic statistics were employed. Empathy was the most important dimension from student's viewpoint which was ranked as the 4th factor in faculty members' view. The faculty members declared the most important dimension to be assurance that was ranked the third in student's viewpoint. There is no dimension with the same rank among different dimensions of educational services between the students and faculty members. This leads the faculty members to advert dimensions which are less important in student's view, so this affects the quality of services from students viewpoint. Therefore, should be taken into account these differences in programming and resource allocation in order to improve the services provided, which is so important from the student's view. Moreover it seems necessary to describe the characteristics of services to the students and identify at services and what to expect from them

Effects of exposure to portland cement dust on lung function in portland cement factory workers in Khash, Iran

The present study was done to assess cement dust exposure and its relationship to respiratory health effects, both acute and chronic respiratory symptoms and ventilatory function impairment among Portland cement factory workers in Khash located in the south part of Iran. A cross-sectional study was conducted at Khash Portland cement producing factory in Iran in 2001. A total of 170 exposed and 170 unexposed employees were selected. Air transmitted personal respirable dust and total dust samples were collected in a full-time [8h/day] shift. Dust level was determined by the gravimetric method. An interviewer-administered questionnaire was used to collect information and history of respiratory health among workers [exposed and unexposed to dust] and measurements of lung function were made using a spirometer in both groups. Concentrations of personal respirable dust ranged from 3.7 mg/m[3] in the kilns to 23 mg/m[3] in the ore crushing area, and total dust ranged from 15 mg/m[3] in the kilns to 95 mg/m[3]. Cough and phlegm, with or without shortness of breath, were significantly related to dust concentration. Measuring pulmonary functions of workers exposed to dust and unexposed group showed a significant decrease in vital capacity, forced vital capacity, FEF[25-75] and Forced Expiratory Volume in the first second [P<0.05]. Findings suggest that occupational exposure to Portland cement dust may lead to higher prevalence of respiratory symptoms and the reduction of ventilator capacity due to existence of quartz in row material of cement dusts. The study revealed that cement dust exposure is associated with acute as well as chronic respiratory health effects. It is recommended that engineering measures must be taken to reduce the dust level in cement factories, accompanied with health monitoring of exposed employees

Effects of proper nutrition education on BMI reduction and changes on FBS, chol and TG rates of type 2 diabetic patients

In this study we have assessed the short-term effectiveness of diabetes education on BMI reduction, changes on [FBS, Chol, TG Rates] of type 2 diabetic patients in relation to proper nutrition. A sample of 125 diabetic patients was systematic randomly chosen. The method chosen for collecting the information [Data] was through questionnaires and laboratory tests [fasting blood sugar, total cholesterol, TG] that was conducted before educational programmes and after constantly education, finally the FBS, Chol, TG and weight were compared. The study showed significant improvements in several aspects of research. This study has shown a high level of illiteracy amongst our patients, which is of course common in developing countries. Diabetics did not gain weight and their relatives lost weight after nutrition curriculum. The mean fasting blood glucose before education was 216.27 mg%, whereas it fell to a mean level of 178.39 mg% after education. The patients had significantly lower serum cholesterol after 7 month education [172 mg%], p = 0.005. The present study clearly demonstrate the great benefits of diabetes self-care education. Most of these studies and our own, have been short term. We conclude that diabetes education is appropriate achievable and worthwhile. The challenge remains as to how to continue benefit long term

Quality gap of primary health care services at Kashan District Health Centers, Iran

This study aims to identify quality gap by assessing users' perceptions and expectations of primary health care quality at Kashan district health centers in Iran. This cross sectional study was carried out during the first three months of 2002. A total of 324 regular female users of primary health care services at Kashan district health centers have been approached. Random sampling of the households covered by each health center was undertaken. The survey instrument was designed around the validated SERVQUAL instrument. Service quality gap was measured by computing the difference between the rating respondents assign to expectations and perceptions statements. Internal consistency of different items of expectations and perceptions were 0.80 and 0.85, respectively using Cronbach's alpha coefficient. The Wilcoxon signed rank test to compare the distributions of the expectations and perceptions. Results show that there were mean differences between clients' expectations and perceptions in all dimensions of service. The largest and smallest mean quality gaps were in the responsiveness and tangibility dimensions, respectively. There were significant differences between clients' expectations and perceptions. The clients' choices clearly show that responsiveness, reliability and assurance are the three most critical dimensions of health care services, respectively. Negative quality gap in all dimensions indicate that there is room for service quality improvement in all five dimensions. These findings suggest that primary health care managers should be looking carefully at each of the dimensions where customers perceive that they are receiving a different service than expected and consider the extent to which they should work on influencing expectations or perceptions, or both

[Survey on quality gap in primary health care in Kashan health centers]

Background: the first basic step in formulating any quality improvement program is recognizing consumers' perceptions and expectations of service quality and determining the quality gap, then adopting guidelines to eliminate the gap

Objective: to assess the service quality gap in Kashan district health centers, based on consumers' perceptions and expectations

Methods: a sample of 300 females' health care consumers completed the research questionnaire. The SERVQUAL instrument administrated to assess the quality of services provided by health centers. To analyze data, descriptive and analytic statistic and correlation coefficient were applied

Findings: results indicated that there was an overall service quality gap between respondents' perceptions and expectations. The smallest gap was in tangibility dimension and the largest in responsiveness. Age and literacy respectively had direct and indirect significant correlation to quality gap

Conclusion: there was a quality gap in services. Thus, improvements are required across all the five dimensions, namely tangibility, reliability, responsiveness, assurance and empathy