Root cause analysis and strategies for reducing falls among inpatients in healthcare facilities: A narrative review.

Background and Aims: Root Cause Analysis (RCA) is a systematic process which can be applied to analyze fall incidences in reactive manner to identify contributing factors and propose actions for preventing future falls. To better understand cause of falls and effective interventions for their reduction we conducted a narrative review of RCA and Strategies for Reducing Falls among Inpatients in Healthcare Facilities. Methods: In this narrative review, databases including Scopus, ISI Web of Science, Cochrane, and PubMed were searched to obtain the related literature published. Databases were searched from January 2005 until the end of March 2023. The Joanna Briggs Institute (JBI) tool was used for quality assessment of articles. To analyze the data, a five-stage framework analysis method was utilized. Results: Seven articles that fulfilled the inclusion criteria were identified for this study. All of the selected studies were interventional in nature and employed the RCA method to ascertain the underlying causes of inpatient falls. The root causes discovered for falls involved patient-related factors (37.5%), environmental factors (25%), organizational and process factors (19.6%), staff and communication factors (17.9%). Strategies to reduce falls involved environmental measures and physical protection (29.4%), identifying, and displaying the causes of risk (23.5%), education and culturalization (21.6%), standard fall risk assessment tool (13.7%), and supervision and monitoring (11.8%). Conclusion: the findings identify the root causes of falls in inpatient units and provide guidance for successful action plan execution. Additionally, it emphasizes the importance of considering the unique characteristics of healthcare organizations and adapting interventions accordingly for effectiveness in different settings.

Impact of knowledge management on job satisfaction and organizational performance among healthcare employees: A structural equation modeling approach.

Background and Aims: Organizational knowledge management (KM) involves creating, preserving, and sharing employees' knowledge. This approach can enhance efficiency, improve performance, and boost job satisfaction (JS) throughout all aspects of the organization. This research aimed to investigate the effect of three variables of KM, JS, and organizational performance (OP) on the employees of the Health and Treatment Network in Haji Abad City. Methods: A study was conducted with 211 employees, such as physicians, nurses, and technicians. These employees worked in various sections, such as hospitals, health centers, rural centers, and emergency centers within the Health and Treatment Network of Haji Abad City. Newman and Kenard's KM, Hersey and Goldsmith's OP, and Smith, Kendall & Hulin's Job Satisfaction Questionnaires were used. The statistical software LISREL 8.8 was used to conduct structural equation modeling (SEM). Results: The results indicate that the structural equation models had a good fit. Significant positive relationships exist between KM processes (creation, retention, and application) and JS. No significant relationship was found between knowledge transfer and JS. The coefficient obtained from SEM between knowledge retention and OP was 0.74, indicating a strong and direct correlation between the two variables. The standardized coefficients for the relationship between knowledge creation and retention and JS were 0.45 and 0.33, respectively. This indicates a positive and direct effect of knowledge creation and retention on JS. All KM processes positively predict OP. Conclusion: The research model had a good fit, and the KM processes had a positive effect on performance and JS. However, no significant relationship was found between knowledge transfer and JS among employees in the Health and Treatment Network. More research is needed to identify mediating variables and factors influencing this phenomenon in healthcare centers.

Hospital Workers Disaster Management and Hospital Nonstructural: A Study in Bandar Abbas, Iran.

INTRODUCTION: A devastating earthquake is inevitable in the long term and likely in the near future in Iran. The objective of the study was to assess the knowledge of hospital staff to disaster management system in hospital and to determine nonstructural safety assessment in Shahid Mohammadi hospital in Bandar Abbas city of Iran. This hospital is the main referral hospital in Hormozgan province with a capacity of about 450 beds and the highest patient admissions. METHODS: The cross-sectional study was conducted in 2013 on 200 healthcare workers at Shahid Mohammadi hospital, in the city of Bandar Abbas, Iran. This hospital is the main referral hospital in Hormozgan province and has a capacity of about 450 beds with highest numbers of patient admissions. Questionnaire and checklist used for assessing health workers knowledge and awareness towards disaster management and nonstructural safety this hospital. RESULTS: This study found that knowledge, awareness, and disaster preparedness of hospital staff need continual reinforcement to improve self efficacy for disaster management. Equipping health care facilities at the time of natural disasters, especially earthquakes are of great importance all over the world, especially in Iran. This requires the national strategies and planning for all health facilities. CONCLUSION: It seems due to limitations of hospital beds, insufficient of personnel, and medical equipment, health care providers paid greater attention to this issue. Since this hospital is the only educational public hospital in the province, it is essential to pay much attention to the risk management not only to this hospital but at the national level to health facilities.

Barriers in Implementing E-Learning in Hormozgan University of Medical Sciences.

BACKGROUND: E-learning provides an alternative way for higher educational institutes to deliver knowledge to learners at a distance, rather than the traditional way. The aim of this study is to identify the barrier factors of e-learning programs in Hormozgan University of Medical Sciences (HUMS) in respect of the students and lecturers' point of view. METHODS: A cross-sectional study based on a questionnaire was conducted among 286 of students and lecturers in the nursing, midwifery and paramedic schools of HUMS. Two hundred and eighty-six participants filled in the questionnaire: 256 students, and 30 lecturers. RESULTS: Results of the study showed a lack of proper training in e-learning courses of the university 182 (69.1%), limited communication with the instructor 174 (68%) and the learners dominance of English language 174 (68%) showed the greatest importance for the students. The awareness about e-learning program was 80% and 43% among lecturers and students respectively.The dominance of English language 26 (86.7%) and lack of research grants for e-learning 23 (76.6%) and lack of proper training on e-learning courses from the university 20 (66.7 %) were the most important barrier factors of implementing e-learning for lecturers. E-learning courses to supplement classroom teaching was a solution that mentioned by the majority of students 240 (93.8%) and lecturers 29 (96.7%) in this study. CONCLUSIONS: The positive perception of e-learning is an important consequence effect in the future, educational development of nursing, midwifery and paramedic schools.

Sharps injuries in the operating room.

OBJECTIVES: We aimed to identify who sustains needlestick and sharps injuries, under what circumstances and what actions are taken to minimize the risk and in response to intraoperative NSSIs. METHODS: The cross-sectional study was conducted in 2013 on 215 operation room personnel in 14 hospitals of the Hormozgan province, Iran. RESULTS: Two hundred and fifty appropriate responders completed the questionnaire (86 %). Anaesthesia 59 (27.4 %) and operation room technicians 55 (25.6 %) sustained the greatest numbers of NSSIs over the past year. Awareness of local protocols was significantly worse in the residents group. The commonest reasons for noncompliance with NSSIs local protocols were not sure of the local protocols 44 (20.4 %) and prolonged operation so unable to leave operation table 37 (17.3 %). CONCLUSIONS: A revision of the local protocol to reduce the time it takes to complete may improve compliance. Education is of paramount importance in making health care workers aware of this issue. The application of safety devices led to a reduction in NSSIs and reduces the risk of blood borne infection as well.

Physicians' perception and attitude toward electronic medical record.

Implementation of an electronic medical record (EMR) system increases efficiency of health services, quality of care and patient satisfaction. Successful implementation of EMRs depends on many factors. The path to quality improvement and financial gain with EMRs lies in getting the greatest number of Physicians to use the system. The main objective of this research is to explore physicians, attitude and perceptions of importance EMRs function, anticipated utilization of EMR functions and also issue impact EMRs. The cross-sectional study was conducted on 133 specialist physicians of three teaching hospitals of Hormozgan Medical Sciences University. The most important finding in this study was the Entry/Display of Diagnoses and Medications (96.3%) and Prescription Alerts drug-drug, allergy and dose checking and formulary management (96.2%) were of greatest importance to respondents. Nuclear medicine, Time trended Clinical Data Display, decision support capabilities, and medical management reporting generated percentage suggesting less than weekly usage. Only a small number of respondents addressed physicians' resistance in compare to another issues impact on EMRs. Understanding physician perceptions and attitude will allow for the development of targeted education to demonstrate the advantages and implementation of EMRs in further and improve physician perceptions of EMRs.

Knowledge, attitude and practice of hospital staff management.

The proper handling and disposal of biomedical waste (BMW) is very imperative. There is a defined set of rules for handling BMW worldwide. Unfortunately, laxity and lack of adequate training and awareness in the execution of these rules leads to staid health and environment apprehension. The objective of the study was to assess the knowledge and attitude of hospital staff to BMW management. The cross-sectional study was conducted on 261 healthcare workers from 9 hospitals, which were randomized from 32 hospitals. The most important finding was a significant (P < 0.05) relationship between the level of education attainments and training in BMW management. Twenty-nine (19.9%) members of government hospital staff and 37 (32.2%) members of staff from the private sector agreed that BMW management is not just the government's responsibility, but one that every member of personnel should share. This finding will help to address the issue more appropriately, and plan for better training programs and monitoring of BMW management systems in hospitals.

Needlestick and sharps injuries among housekeeping workers in hospitals of Shiraz, Iran.

BACKGROUND: Needlestick and sharps injuries (NSSIs) are one of the major risk factors for blood-borne infections (BBPs) at healthcare facilities. This study examines the current prevalence of NSSIs among housekeeping workers engaged in the handling and disposal of biomedical waste (BMW) at government and private hospitals in Shiraz, Iran, and furthermore, explores strategies for preventing these injuries. FINDINGS: Using a cross-sectional study design, NSSI's and associated protective measures for housekeeping workers throughout hospitals in Shiraz were evaluated from 2009 onwards. Using a questionnaire, data was collected for 92 workers who had engaged directly with BMW. Data was analyzed using Chi-square, student t-test and where appropriate, SPSS version 12. 90.2 % of housekeeping workers were warned of the dangers associated with waste, 87.5 % in government and 93.2 % in private hospitals (P = 0.0444). 83.7 % had attended educational programs on biomedical waste (BMW) management and injury prevention at their hospital in the preceding year. 16.3 % had not been trained in biomedical waste management (P = 0.0379) and 88.9 % had a sufficient supply of safety wear. CONCLUSIONS: NSSIs are a common risk factor for infection among health care workers within hospitals in Iran. For the effective prevention of these injuries, health boards and hospital trusts need to formulate strategies to improve the working conditions of health care workers, discourage the excessive use of injections, and increase their adherence to universal precautions.