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Pharmacies are a major component of health systems and a major part of health service provision. This study aimed at identifying and introducing the potentials of pharmacies in health promotion. This was a systematic review that searched PubMed, Web of Science, Science Direct, SID, Magiran, and IranMedex from February 1990 to September 2018 for related materials. The main search keywords were (pharmacy services), (community pharmacy services), (retail pharmacy services), (pharmacy practice intervention). Inclusion was limited to those papers that discussed the health-promoting services provided in the pharmacies. The quality of included papers was assessed by the Critical Appraisal Skills Program checklists. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses chart was followed in all stages of the study. Of the 4156 papers retrieved, 18 met the inclusion criteria and included in the analysis. Study findings were categorized into three main categories: Health and prevention services, services related to treatments, and the awareness about the pharmacies' functions. The health and prevention category consisted of education, vaccination, screening and prevention of diseases, family planning, blood pressure monitoring, quitting smoking, limiting alcohol, and weight management. The treatment-related services consisted of adherence to medication, medication consultation, minor pains, and emergency medical services. Pharmacies can provide a wide variety of services besides the medications. Purposeful development of the services provided in the pharmacies and involving them in an extended array of services may accelerate the health promotion activities of the health system and result in improved quality of life and decreased costs. To do so, the legal, educational-skill, and pricing challenges should be resolved.
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AIM: The purpose of this study was to investigate the effects of delay in the operation and counseling on postoperative complications and mortality rates in elderly patients. METHODOLOGY: The present study was a descriptive cross-sectional research. Population of this study was the entire elderly hospitalized patients who aged over 55 years for emergency orthopedic surgeries in a teaching hospital in Tehran. Surgery delays were then determined after examining the checklists, and the relationship between the variables and surgery delays, number of preoperative counseling, complications, and mortality rate was evaluated. Data were analyzed using the Mann-Whitney U-test and Pearson correlation coefficient in SPSS 18 at a 0.05 significance level. RESULTS: Overall, 89.9% of the patients had counseling. The average hospitalization days were 5 days until surgery, and the standard deviation was 0.50. The mean counseling number was 5.5. The relationship between number of counseling and surgical delays was significant. Delay in surgery in this age group, mortality, and the chances of death have become 2.7 times more than who had not a surgical delay. No significant relationship was observed between surgery delay and the incidence of Deep Venous Thrombosis (P = 0.102), postoperative sepsis and Myocardial Infarction (P = 0.337), embolism (P = 0.505), and postoperative Cerebrovascular Accident (P = 0.153). CONCLUSIONS: The delay in surgery in the elderly causes an increase in mortality. Considering the findings of this study and the importance of emergency orthopedic surgeries in the elderly, to reduce the surgical delays and the mortality rate in the elderly, the establishment of a surgical team for elderly patients in hospitals is recommended.
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INTRODUCTION: Human resource supply is considered as one of the most vital factors in achieving organizational goals, and human resources are the most valuable factor in the production and delivery of services. Labor shortages and surpluses could downgrade the quality of services offered to patients. Considering the seriousness of this issue, this study aimed to investigate the status of human resources in Iran hospitals. METHODS: The narrative review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The key terms "Human Resource," "Human Resource Management," "Staff," "Workforce," "Hospital," "emergency," "staff nursing," "medical," "clinical personnel," "administration," "physician personnel," "non clinical personnel," "hospital personnel," "human development," and "Iran" were used in combination with Boolean operators OR and AND. The Institute for Scientific Information's Web of Science, PubMed, Scopus, ScienceDirect, Ovid, ProQuest, Wiley, Google Scholar, and the Persian database were searched. RESULTS: The research findings revealed that Iran's hospitals have no uniform distribution of human resources. In spite of the concentration of labor forces in some positions (eg, laboratory, radiology, operating room, anesthesia, and midwifery), other positions occupied by physicians and nurses are experiencing serious shortages of human resources, affecting the quality of the provided services. CONCLUSION: With respect to the study findings, planning to compensate for staff shortages and achieving personnel standard levels as well as providing the grounds for training the heads of wards for proper human resource management and planning would lead to an increase in the efficiency and effectiveness of hospital activities.
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BACKGROUND: Considering patients' needs and expectations in the process of healthcare delivery improves the quality of services. This study aimed to investigate the responsiveness of general public and private hospitals in Mashhad, Iran. METHODS: In this cross-sectional and explanatory study, hospitalized patients (with at least 2 days of stay) in general private and public hospitals in Mashhad were investigated. In total 425 patients (259 from private and 166 from public hospitals) were selected using a stratified and simple random sampling. Standard responsiveness questionnaire was used as the data collection tool. Data were analysed using descriptive statistics, independent t-tests and ANOVA by SPSS 16 at a significance level of 0.05. RESULTS: Access to the social support during hospitalization as well as confidentiality of the patient's information achieved the highest score (3.21±0.73) while the patient participation in decision-making process of treatment received the least score (2.34±1.24). Among the research population 1.6%, 4.1%, 17.6%, 63.3% and 13.2% commented on the responsiveness level as very low, low, moderate, good, and excellent, respectively. There was no significant difference between the overall responsiveness scores of public and private hospitals ( P ≥0.05). CONCLUSION: The hospitals have enough potential to improve various aspects of their responsiveness. We suggest a number of measures can help improve the non-clinical aspects of care. These include: using educational courses to improve the knowledge and attitudes of medical and nonmedical staff, changing the resource allocation method, and using quality tools such as reengineering to modify the healthcare delivery processes.
