RESUMO
PURPOSE@#The median time from the event leading to the spinal cord injury (SCI) to the time of decompressive surgery is estimated to be 6.9 days in Iran, which is much longer than the proposed ideal time (less than 24 h) in published guidelines. The current qualitative study aimed to determine the reasons for the observed decompression surgery delay in Iran from the perspective of neurosurgeons.@*METHODS@#This qualitative study is designed to perform content analysis on the gathered data from face-to-face semi-structured interviews with 12 Iranian neurosurgeons.@*RESULTS@#The findings of the current study suggest that patient-related factors constitute more than half of the codes extracted from the interviews. Overall, the type of injury, presence of polytrauma, and surgeons' wrong attitude are the main factors causing delayed spinal cord decompression in Iranian patients from the perspective of neurosurgeons. Other notable factors include delay in transferring patients to the trauma center, delay in availability of necessary equipment, and scarce medical personnel.@*CONCLUSION@#In the perspective of neurosurgeons, the type of injury, presence of polytrauma, and surgeons' wrong attitude are the leading reasons for delayed decompressive surgery of individuals with SCI in Iran.
Assuntos
Humanos , Descompressão , Irã (Geográfico) , Neurocirurgiões , Traumatismos da Medula Espinal/cirurgiaRESUMO
The National Spinal Cord Injury Registry of Iran (NSCIR-IR) is a not-for-profit, hospital-based, and prospective observational registry that appraises the quality of care, long-term outcomes and the personal and psychological burden of traumatic spinal cord injury in Iran. Benchmarking validity in every registry includes rigorous attention to data quality. Data quality assurance is essential for any registry to make sure that correct patients are being enrolled and that the data being collected are valid. We reviewed strengths and weaknesses of the NSCIR-IR while considering the methodological guidelines and recommendations for efficient and rational governance of patient registries. In summary, the steering committee, funded and maintained by the Ministry of Health and Medical Education of Iran, the international collaborations, continued staff training, suitable data quality, and the ethical approval are considered to be the strengths of the registry, while limited human and financial resources, poor interoperability with other health systems, and time-consuming processes are among its main weaknesses.
RESUMO
Web-based technologies provide new opportunities for education, research and professional development of nursing. Nurses have few opportunities to use the Internet due to managers' obligations not to use the Internet in work hours, and their traditional attitudes to nursing practice. Establishment of a national nursing portal is a useful way to resolve some of these problems. The purpose of the present study was to investigate the experiences of development of nursing portals in some countries and provide helpful recommendations. This was a descriptive- comparative study. Using systematic review of the literature, the least features for nursing portal structures and contents were identified. Then, the identified features were assessed in selected countries through observation or communication with the portal board. Personalization, user's profile, search engine, platform-independent display, SSO capability, security mechanisms and collaborative capabilities, clinical guidelines, continuing education, electronic learning courses, and evidence-based nursing processes were common features in the nursing portals. Development of a specialized comprehensive portal that has all of the desirable features can be achieved through clear definitions of strategies on portal development, maintenance, and analysis of user's requirements. The main requirement to integrate services and contents provided by the portal include specific and integrated structure of all entities in nursing services systems