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ASSESSMENT OF MEDICAL WASTE MANAGEMENT IN EDUCATIONAL HOSPITALS OF TEHRAN UNIVERSITY MEDICAL SCIENCES
M. H. Dehghani, K. Azam, F. Changani, E. Dehghani Fard
Iranian Journal of Environmental Health Science & Engineering , 2008,
Abstract: The management of medical waste is of great importance due to its potential environmental hazards and public health risks. In the past, medical waste was often mixed with municipal solid waste and disposed in residential waste landfills or improper treatment facilities in Iran. In recent years, many efforts have been made by environmental regulatory agencies and waste generators to better managing the wastes from healthcare facilities. This study was carried in 12 educational hospitals of Tehran University of Medical Sciences. The goals of this study were to characterize solid wastes generated in healthcare hospitals, to report the current status of medical waste management and to provide a framework for the safe management of these wastes at the considered hospitals. The methodology was descriptive, cross-sectional and consisted of the use of surveys and interviews with the authorities of the healthcare facilities and with personnel involved in the management of the wastes. The results showed that medical wastes generated in hospitals were extremely heterogeneous in composition. 42% of wastes were collected in containers and plastic bags. In 75% of hospitals, the stay-time in storage sites was about 12-24h. 92% of medical wastes of hospitals were collected by covered-trucks. In 46% of hospitals, transferring of medical wastes to temporary stations was done manually. The average of waste generation rates in the hospitals was estimated to be 4.42kg/bed/day.
Choice of Delivery in Tehran and Some Related Factors
Masoomeh Alimohammadian,Mamak Shariat,Mahmood Mahmoodi,Fatemeh Ramezanzadeh
Journal of Family and Reproductive Health , 2007,
Abstract: Objective: This study assessed the influence of maternal request on elective cesarean rate and related factors in maternity hospitals in Tehran.Materials and Method: This cross sectional descriptive analytic study was performed via a two-step random sampling technique, using data from 824 pregnant women who attended the maternity hospitals in Tehran in 2001. A questionnaire covering past and present obstetrical history and demographic characteristics was completed for each mother. SPSS software was used for data analysis. Descriptive analysis and inference tests, including chi-square and t-tests were used. Logistic regression test was also used to find the correlation between variables. P value less than 0.05 was considered for statistical significance.Results: Totally 66.5% of mothers underwent cesarean and 33.5% had normal vaginal delivery. From cesarean cases 72% were elective and of these 22% were done upon maternal request. It was shown that 71% of mothers who selected cesarean had no scientific reason. Also, 65% of doctors suggested cesarean for their patients without any true medical indication. The majority of elective cesareans performed on maternal request were done in private hospitals (86% in private vs. 14% in public hospitals) (P<0.0001). High educational , employment status and first pregnancy significantly increase the demand for cesarean section.Conclusion: Increasing the level of awareness and attitude of mothers and providing painless normal vaginal delivery as well as vaginal delivery after previous cesarean, the frequency of unnecessary cesareans and related complications can be decreased.
Influence of different factors on risk of complications of tubal ligation surgery: Study of 1780 women admitted to 13 hospitals in Tehran
Ramezan Zadeh F,Khalaj Abadi Farahani F,Sadat Hashemi SM
Tehran University Medical Journal , 2000,
Abstract: Tubal ligation is one of the most effective and reliable methods of contraception and of successful program of birth control in Iran. Present study was done to evaluate factors affecting risk of complications during tubal ligation surgery. We studied 1780 women that had tubal ligation in 13 hospitals in Tehran during the years 1993-95. Data on operation were collected by questionnaire and analyzed using logistic regression method. Risk of complications was increased in women had had operation after vaginal therapy, in luteal phase, after cesarean section and in follicular phase, respectively. Modified pomery, pomery and parkland methods of operation were ascendingly related to increased risk of complications. Age, history of pelvic pain, method of anesthesia, incision size and time of operation were not significantly correlated with complications. Frequency of complications was higher in women that had other procedures during surgery. We suggest that tubal ligation be done after vaginal delivery and by modified pomery method.
The Survey of Educational Facilities and Present the Kinds of Program Staff Development of Nursing Staff in Hospitals of University of Medical Sciences & Health Services in Tehran
Z. Monjamed,F. Shekarnia,Sh. Varaei,N. Bahrani
Hayat Journal of Faculty of Nursing & Midwifery , 1999,
Abstract: This study is a descriptive research in order to determine educational facilities and present the kinds of program staff development of nursing office in hospitals of university of medical sciences and health services in Tehran, IRAN. The purpose of this research was determinated of the educational space (clossroom, library, Lecture and conference room), educational equipment, educational staff patterns, kinds of nursing staff development program and comparing between educational facilities and present the kinds of nursing development program of nursing office in three medical science university in Tehran. The units that participated in this research was 41 educational facilities and kinds of nursing staff development program of nursing office in three medical science university in Tehran (Tehran, Iran and shahid Beheshti) and no samphing was made. The tools was check list and Questionnarie. Each variable compared with educational standards of hospitals. (Standard 1100% excellent, desire was above 75% and undesired was under 75% and each 100 active bed haveing one educational supervisor)."nThe finding indicated that scale confirmity with standard about educational space in three university was 50% (undesirable) and about educational equipment was 56% (undesirable) and about educational staffing pattern was 79% (desirable) and present kinds of nursing staff development was 56.5% (undesirable). The finding indicated that university medical of science Iran 66.5%, Shahid Beheshti 59.76% and Tehran 55.3% Scale confirmity with stundards have prossess.
Pulmonary Function Study Between Formaldehyde Exposed and Non-exposed Staffs at Some of the Tehran Educational Hospitals  [PDF]
Mohammad Pourmahabadian,Kamal Azam,Mehdi Ghasemkhani
Journal of Medical Sciences , 2006,
Abstract: The present study was conducted in seven large hospitals of Tehran University of Medical Sciences. Pulmonary function tests have been made through spirometry. Spirometric test results of 124 staffs who had directly exposed to formaldehyde have been recorded. Then obtained data were compared with 56 non-exposed persons at administrative affairs sections. Analyzing of the data showed that lung symptoms such as coughing, phlegm, chest tightness feeling and dyspnea among exposed persons are significantly more than non-exposed group. Also, the results of pre and post-shift pulmonary function tests revealed that significant relationship between vital lung capacities of all exposed persons especially in pathology labs staffs are existed (p<0.002). But, no significant relationship observed in non-exposed persons and surgery room staffs that exposed with low concentration of formaldehyde. In addition, comparison of the results between exposed and non-exposed groups especially in pathology labs staffs with those data in surgery and endoscopy groups showed significant variations (p<0.05). Relative distribution of smokers in case and control group was 23.1-33.3 and 30.4%, respectively and no significant relations were founded between them.
The Review on Lifestyle and its Relation with the Pregnancy Outcomes in the Pregnant Women Coming to Educational Hospitals of Tabriz in 2004
Sehhatie Shafai Fahimeh,Sadeghi Khamneh Sedigheh,Hossein Kushavar,Sheybaei Fatemeh
Research Journal of Medical Sciences , 2012,
Abstract: The life style which is called for individual life manner is described as one of the important factors which influence the health. The health and progress of every society to some extent is dependent on the health of women, the pregnancy and child delivering have had significant effect on the women`s health and hygiene and is accounted for national health and important indexes. On the other hand, the life style has had long-term and permanent effect on the health of mother and child. Therefore, this research is done for objective reviewing pregnant women`s life style and its relation with pregnancy outcomes in pregnant women coming to educational centers of Tabriz. This research is cross-sectional study in the form of comparative which in it 385 women coming to AL-Zahra and Taleghani Hospitals studied; they have had a unit characteristics of research case, The procedure was in the aim of choice and with the help of questionnaires containing three parts socio-individual characteristics; life style and the pregnancy outcomes, the data collected and analyzed with the help of computer software SPSS/Win11 and statistic tests ANOVA, correlation and t test. The research results showed that the life style 44.7% of pregnant women studied were middle and 55.3% were good, which only in the field of physical exercise were poor and in the rest cases the situation evaluated in the majority was good and from point view of statistic, the relation between life style and weight of newborn was significant (p = 0.006), with the use of Pearson`s ratio scales it was defined that the relation between physical exercise (from part of life style) and pregnancy age (r = 0.1 and p = 0.046) and relation between nutrition (from part of life style) and the weight of newborn and pregnancy age (in order p = 0.033 and p = 0.005) was significant. Regarding to research findings, there is relation between the life style situation and nutrition with the weight of newborn and also nutrition and physical exercise with pregnant age, for helping to promote women`s health during pregnancy and improving the pregnancy outcomes with education to the style of healthy life (regular exercise, healthy nutrition, not to smoke, suitable caring himself and acceptable social relation) are suggested from hygienic personnel during this period.
Study of continuation of using norplant in hospitals of Tehran Medical Sciences University, 1990-94
Nabaie B,Borgheie A
Tehran University Medical Journal , 1998,
Abstract: Norplant is one of the most effective contraceptive divices with low failure rate and long effect, which has been used in governmental centers, since 1992. considering high costs of this program, this study was designed to specify norplant continiuation rate, the causes of discontiniuation and also its complications. This descriptive study was done by reviewing women using this method in Hospitals of Tehran Medical Sciences University. The results indicate that since 1992 to 1997, 305 women have used Norplant. The mean age of them has been 27 years and 17% are employed. During the follow-up period (55 months) 43 percent have discontiniued using Norplant. The mean continiuation period in this group has been 14.6 month in 0-55 months limit. According to this study, the most common side effects of Norplant are menstrual irregularities including sporting, and amenorea, and neuropsychiatric disorders. No case of pregnancy has been reported in this period
Obstetrics Risk Management in 5 Iranian Hospitals (Tehran-2012)  [PDF]
Nasrin Changizi, Farah Babaee, Hamid Ravaghi, Zahra Farahani
Open Journal of Obstetrics and Gynecology (OJOG) , 2015, DOI: 10.4236/ojog.2015.55038
Abstract:

Background: Risk management is improving quality of health care services and creating a safer system of care. We determined the main maternal and fetal risks in five Hospitals (Tehran-Iran) to offer some practical strategies to decline obstetric adverse events and provide better pregnancy outcome. Methods: A descriptive, cross-sectional study was carried out in 5 Iranian hospitals (2011-2012).Twelve Obstetricians/perinatalogists and midwives from 5 hospitalswho were in charge of Maternity Units, were our assistants in these hospitals. We organized a secretariat including Obstetricians/perinatalogists and midwives. The principles of Obstetrics Risk Management were introduced to them in a 2 days’ workshop. Then the delegates from each hospital were asked to report the most common obstetrical complications of their hospitals. The main results were 24 complications. Then for sorting these risks we asked them to do scoring of the 24 complication with 1 - 10 grading in 4 aspects of probability of occurrence, possibility of prevention, priority of interventions and short term response to interventions. Post partum haemorrhage, labor management problems, and neonatal hypothermia got the highest scores in these regards, and then these 24 items were categorized in 2 groups of risk assessment and hospital management. Finally based on Risk Management Rules in Clinical Governance, the complications analysis was done with use of failure mode, effects analysis and practical strategies to decline obstetrical adverse events were suggested. Results: We understood all reported complications had common infrastructural problems: defects in Risk Assessment and Hospital Management Policies. We focused on basic infrastructural management in these 2 main subjects and in these two: our main problems were related to staff management and hospital management issues. Conclusion: Since managerial and staff dependent problems were our main problems, these two should be considered as our main priorities in risk management program.

Evaluation of clinical education departments of Tehran hospitals
Farzianpoor F,Bazargan A
Tehran University Medical Journal , 1999,
Abstract: The present research evaluated the teaching of treatment hospitals of medical sciences universities in Tehran. The aim of research was a clinical diagnosis on particular nature of medical specialty, sub specialty fields promoting the quality of medical education and offering special services in teaching hospitals in comparison with standard measurements. An effective method in recognizing the strong and weak points of teaching and treatment services in teaching hospitals is choosing the Accreditation Model, that played a great role in this research. The steps to perform the model are as follows: 1) At the beginning, the medical education system criteria was mentioned according to model consisting of five parts: input-process-intermediate output-final input and outcome. The evaluation factors are: 1- Managing, treatment, teaching and research sections. 2- The theoretical, practical and experties of the faculty members. 3- The educational progress of assistants. 4- Resources, facilities, equipment and financial services in teaching of treatment center. 5- The ability to carryout teaching of treatment and clinical projects. 6- Patient satisfaction. 2) To determine if the variables are standard, the national and international documents (teaching standards of Cebec, Canada) were studied to compare the standards to the medical education system in medical hospitals. The viewpoints of board of directors in teaching hospitals were gathered. At last, the final model was devised according to the viewpoints and the final standard confirmed, 96.7% positive votes. 3) To determine the percentage role of evaluation factors, called the basis the investigation forms were filled by the managers of the hospitals according to interview and Delphi technique. The importance of each basis was investigated and confirmed in two stages in teaching hospitals in Tehran and all over Iran, according to the information. 4) According to the standards, many questions were constructed. The board of directors in teaching of treatment sections in every selected hospital determined the rank of each criteria on the hospital where they worked. After gathering the data by the investigator and determining the grades, the following linear-formula will be applied and the criteria to judge a teaching hospital on its credibility will be available. Y=a1x1+a2x2+... akxk. 5) Based on the data collected and the application of the linear formula, the hospitals in the study proved to comply with the accreditation standards. They were rated as satisfactory.
The Amount and Causes Deductions of Bills in Tehran University of Medical Sciences Hospitals
R Safdari,R Sharifian,G saeedi Marjan,N Masoori
Payavard Salamat , 2011,
Abstract: Background and Aim: Annually, large amounts of fees that paid by hospitals will not be reimbursed as deductions by health insurances and takes irreparable financial losses to hospitals. The purpose of this study was to determine the amount of deductions imposed on hospital bills of Tehran University of Medical Sciences and their causes related to documentation. Materials and Methods: The present research was a cross-sectional and descriptive study performed in year 2009 on educational hospitals of Tehran University of Medical Sciences. All deductions reports related to Medical Services and Social Insurance related to year 2008 was collected from Income Unit of hospitals. The amount of deduction of each hospital was extracted and organized in the form of comparative tables. Data was analysed by descriptive statistics and Excel application. Then, the amount, type and causes of annually deduction of each hospital was determined. Results: Most deductions imposed on inpatient bills have been related to the tests, appliances, medicine, residency, surgeon commission, and anesthesia and for outpatient bills have been related to visit, tests and medicine which most of them have been created due to documentation deficiencies. Conclusion: Most of deductions are due to unfamiliarity of care staff with documentation requirements of insurance organizations. Therefore it is necessary to use a multi-aspect mechanism including education of documentation principles to staff, supervision on record control in the Medical Record Unit and establishment of a committee by university for related activities.
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