ABSTRACT
BACKGROUND: To assess prevalence and predictive factors for Nosocomial Infection (NI) in the military hospitals. METHODS: PubMed, Scopus, Cochrane and PreQuest databases were systematically searched for studies published between Jan 1991 and Oct 2017 that reported the prevalence of NI and predictive factors among military hospitals. We performed the meta-analysis using a random effects model. Subgroup analysis was done for heterogeneity and the Egger test to funnel plots was used to assess publication bias. RESULTS: Twenty-eight studies with 250,374 patients were evaluated in meta-analysis. The overall pooled estimate of the prevalence of NI was 8% (95% 6.0-9.0). The pooled prevalence was 2% (95% CI: 2.0-3.0) when we did sensitivity analysis and excluding a study. The prevalence was highest in burn unit (32%) and ICU (15%). Reported risk factors for NI included gender (male vs female, OR: 1.45), age (Age≥65, OR: 2.4), diabetes mellitus (OR: 2.32), inappropriate use of antibiotics (OR: 2.35), received mechanical support (OR: 2.81), co-morbidities (OR: 2.97), admitted into the ICU (OR: 2.26), smoking (OR: 1.36) and BMI (OR: 1.09). CONCLUSION: The review revealed a difference of prevalence in military hospitals with other hospitals and shows a high prevalence of NI in burn units. Therefore careful disinfection and strict procedures of infection control are necessary in places that serve immunosuppressed individuals such as burn patient. Moreover, a vision for the improvement of reports and studies in military hospitals to report the rate of these infections are necessary.
ABSTRACT
BACKGROUND: The achieve uses 7 variables: ability; clarity; help; incentive; evaluation; validity; and environment, to provide leaders and staffs with the necessary tools to improve performance, and help managers to determine cause of performance problem. And create change strategy for solving those problems. We try to determine factors affecting the performance of nurses, base on this model in selected hospital of Isfahan (Iran). MATERIALS AND METHODS: This was a descriptive-correlation survey. The population of study was 85 nurses of 9 hospitals in Esfahan. Data gathering was done via achieve questionnaire. Reliability was calculated by Cronbach's alpha (r = 0.85). Data analysis was done by using SPSS 16. RESULT: The ability and help variables were the most important factors in improving performance of nurses and validity and evaluation were less important. CONCLUSION: [corrected] Today, staff effectiveness is one of the important problems in health care organization. In fact, performance improvement is the most important step for organization improvement.
ABSTRACT
BACKGROUND: Many diagnostic and treatment procedures are done in hospitals and clinics. Offering services in these areas have a prominent role in promoting patients' satisfaction levels and their prospective about health services. OBJECTIVES: This study is going to assess the satisfaction levels of patients referring to the six military hospital clinics in Iran. MATERIALS AND METHODS: In this cross-sectional study, 330 outpatients and 696 inpatients admitted to the six military hospital clinics in Iran were randomly questionnaires from June to August 2008. Basic socio-demographic data along with a clinic satisfaction level assessment questionnaire were filled for outpatients. A hospital satisfaction level assessment questionnaire also was applied to record inpatients' data. All collected data were recorded and then analyzed tests X2 and ANOVAs was used and with significantly lower levels of 5% (P < 0.005). RESULTS: We found that 96% of the study population was satisfied with clinic services and more than 98% of the respondents were satisfied with inpatient ward services. In clinic services, the satisfaction level in numbering and waiting time, access to the clinic, physical environment, welfare and helping facilities, and personnel and physicians' behavior were 78.2%, 80.6%, 89.1%, 91.2% and 93.6% respectively (P < 0.001). With regard to inpatient services, the satisfaction level of patients with physician services, nursing routine services, behavior of nurses, nutritional condition, welfare facilities, reception unit services, discharge unit services and accounting unit services were 94.7%, 91.9%, 91.9%, 91.5%, 91.5%, 91.2%, 90.8% and 88.2%, respectively (P = 0.013). CONCLUSIONS: On the basis of the findings, most respondents reported having a favorable satisfaction with clinic and hospital health services. However, planning to reduce patient's waiting time in clinics and training physicians to offer more instructions to the patients seems necessary. Since discharge and accounting unit services had the lowest satisfaction levels of inpatients services, responsible managers must have special attention to these official processes.