Adherence to informed consent standards in Shiraz hospitals: matrons' perspective.

BACKGROUND: Informed consent is an important part of the patients' rights and hospitals are assigned to obtain informed consent before any diagnostic or therapeutic procedures. Obtaining an informed consent enables patients to accept or reject their care or treatments and prevent future contentions among patients and medical staff. METHODS: This survey was carried out during 2011-2. We assessed adherence of 33 Shiraz hospitals (governmental and non-governmental) to informed consent standards defined by Joint Commission International (JCI) Accreditation, USA. The questionnaire was designed using the Delphi method and then filled out by hospital matrons. We calculated valid percent frequency for each part of the questionnaire and compared these frequencies in governmental and non-governmental hospitals using analytical statistics. RESULTS: Considering 63% of the hospitals that filled out the questionnaire, no statistically significant difference was observed between the governmental and non-governmental hospitals in adherence to informed consent standards. CONCLUSION: This study shows a relatively acceptable adherence to standards about informed consent in Shiraz hospitals but the implementation seems not to be as satisfactory.

Comparing Tobacco Use Knowledge, Attitudes and Practices between Engineering Students at a Public and Islamic Azad University in Shiraz, Iran 2011.

BACKGROUND: To compare the level of knowledge, the attitudes, and practices with regards to tobacco use between Iranian students at a public (PBU) and Islamic Azad (IAU) university. METHODS: A cross-sectional design was used in this study. As the number of students at the IAU were three times greater than that of the PBU, we selected 150 students from the PBU and 450 students from the IAU using simple random sampling. A 57-item survey instrument was utilized for this study. The collected data were recorded by SPSS version 15 software and then it underwent statistical analysis using descriptive statistics and ANOVA to compare the difference between means of knowledge, attitude and practice scores. Logistic regression analysis was conducted to identify variables that have an independent association with students smoking and to describe possible variations in these relationships. The P value level for statistical significance was set at 0.05. RESULTS: From participants, 46.8% were females, 10% of 327 students reported being daily smokers; of these, 84% were from the IAU. Totally, among the 107 smokers, 61 (57%) and 29 (27.1%) were water pipe and cigarettes smokers, respectively. Ninety-three IAU students (21.7%) and 30 PBU students (20.7%) reported smoking during the past 30 days. The mean of the knowledge items between the students of IAU was lower than PBU students. Female gender, smoking in the home, and allowing visitors to smoke in the home were significant predictors of smoking in the past 30 days in PBU, respectively. In IAU, female gender, smoking by friends, and health status were predictors for smoking in the past 30 days. CONCLUSIONS: Future studies should assess the factors affecting smoking initiation, as well as effective techniques for the prevention of smoking initiation and substance abuse in Iranian adolescents and young adults.

Effect of surgical safety checklists on postoperative morbidity and mortality rates, Shiraz, Faghihy Hospital, a 1-year study.

OBJECTIVE: The study intent was to (1) encourage the use of surgical safety checklists and (2) measure the effect checklists have in reducing surgical complications. DESIGN: An interventional study designed to improve postsurgical outcomes was performed. SETTING: The study site was a 374-bed referral educational hospital in Shiraz, Iran, with 6 operating rooms. The study lasted 6 months. PARTICIPANTS: Patient selection involved a convenient sampling method with all eligible patients entering. INTERVENTION: Our checklist covered 3 surgical stages--before anesthesia, immediately before an incision, and before moving the patient to a recovery room. Persons included were operating room team members. MAIN OUTCOME MEASURES: Rates of postsurgical complication before and after application of the surgical safety checklist underwent comparison. RESULTS: Incidence of any complication before and after intervention was 22.9% and 10% (P = .03). Five checklist items were in total compliance. The most common complication was surgical site infection. Implementation of the checklist, responsibility in 2 stages, such as time out and sign out, were significant (P < .05). In most cases, these items reflected the performance of surgeons and anesthesia professionals as compared with the World Health Organization Surgical Safety Checklist. CONCLUSION: Complications decreased by 57% after intervention. Both high patient information detection and elevated levels of cooperation by surgical personnel were observed. Compliance likely helped prevent some adverse effects associated with surgery.