Yafteh

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Background: An assessment of the growth of Iranian children has shown that a large percentage of Iran’s children are afflicted with growth failure. Community participation is one of the principles emphasized by the World Health Organization as necessary for development of health services. The goal of this study is to evaluate the role of the presented model of mothers’ participation on mothers’ practice concerning the development and nutrition of their children. Materials and methods: A community-based field trial was conducted with 74 mothers with children less than three years of age. A model was designed to increase mothers’ participation. On the basis of this model, a group of mothers’ volunteered and were instructed in the subjects of growth monitoring and child nutrition. Then the mothers who received training instructed other beneficiaries on the basis of the model. The plan was evaluated by the CIPP evaluation model. Changes in the mothers’ knowledge and practice scores were assessed by a questionnaire before and after intervention. Results: The mean score of the mothers’ knowledge, before and after intervention, was 23 and 43 respectively, and the mean score of their practice, before and after intervention, was 47.3 and 60.2 respectively. In the two cases, the difference was meaningful at P<0.001. This plan considerably increased the individual and social capabilities sincluding self confidence, of the participants. Different effects of the project—including impact, effectiveness, sustainability and transportability—were assessed through the CIPP evaluation model, and special indices, criteria and standards were determined for each part. Conclusions: The considerable improvement in the knowledge and practice of mothers concerning the growth and nutrition of their children and the considerable increase in individual and social capabilities of the beneficiaries of the plan show the efficacy of this model. In addition, as the design of the present model is based on the cultural and social background of Iran according to its health system, the model can be used in other regions to develop other health services.

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Background: Hospital standards are one of the valuest concepture items in an organization and hospital management. The research purpose was determination of luchs of hospital evaluation current way throght the comparission with ISO quality management standards and suggestion of a model to hospital standard development based on aquired findings. Materials & Methods: This research is a descriptive – comparative study that was been doing on hospital standards, »B Hospital evaluation handout« in comparission with »1994-29000 ISO principles«. In first stage, theorrical analysis and comparission of handout items with ISO necessities was done, then 8 stage model of hospital standards development was provided through the use of brain storming method to lists determination, multiple vote taking method, nominal team technic for chosing, AHP hierarchy analysis process methods and selection matrix for priority ullocation and benchmarking to choices. The provided model was authenticated with using delph: like method. Results: Totally, 853 question were evaluated about conforming with ISO principles in »B Handout« and ISO items were brought 1026 onces in front of 853 items of handout. In this adaptation »quality internal ausits«, »process control« and »inspection and test«items from 1994-9000 ISO standards were repeated 339, 302 and 158 once, orderlly that in total, they consist of 77.8% of writted items and other 17 items were consisted only 22.2% of the whole of ISO items repeatting onces that 7 items from these were never in »B hand out« at all and also 5 other items were less than 7 evidence (from 1010 questions). Conclusion: Writing method of evaluation items in »B hand out« has significant difference with what is done in ISO audit. Research findings showed that in spite of leaping that »B hand out« developing had in national. There are serious lacks in hospital compelete evaluaton so that consider a hospitals system, means and content beacause of lack of enough experiment in standard development based on ISO principles.

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Background: Nurses have a major role in continued care and health promotion. Thus, their productivity is very important. Although many factors affect productivity, but evaluating the personnel's perception about it has a pivotal role in productivity improvement. Moreover, evaluation is a factor that can facilitate or impede productivity. Materials and Methods: This study was done in qualitative mode. Purposive sampling and open interviews were done to gather data. Content analysis approach with constant comparative analysis was used to analysis data. Findings: Nurses consider productivity both quantitatively (efficiency) and qualitatively (effectiveness). But most of them think about productivity from qualitative view. They consider the effective care which they provide to patients. One of the factors facilitating or impeding productivity is evaluation. Effective evaluation can increase productivity, and current barriers impede nursing team productivity from their viewpoint. Conclusion: Effective evaluation can improve productivity. Thus, it is suggested that current evaluation process be revised extensively.

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Mazaheri Sh1, Fazlian MM2, Hossein Zadeh A3 1. Assistant Professor, Department of Neurology, Faculty of medicine, Hamedan University of Medical Sciences 2. General practitioner, Specialty and Subspecialty Hospital of Besat, Hamedan University of Medical Sciences 3. General practitioner, Hamedan Health Center Abstract Background: Multiple Sclerosis (MS) is one of the most common causes of chronic neurological disability in young adults and geographical diversities and differences have been reported in its occurrence. For more concise data about MS in the West of Iran, in this study, the clinical and epidemiological features of MS patients were evaluated at the University Hospital of Hamedan. Materials and methods: Data for 155 MS patients attending Hamedan University of Medical Sciences’ MS Clinic between the years of 2004 and 2005 who had fulfilled Poser criteria for clinically definite MS were reviewed. Moreover, early and late MS onsets for clinical and epidemiological differences were compared. Results: The early onset MS was reported in 23(14.83%) subjects who were 18 or less years old of whom 7(30.44%) were male and 16(69.56%) were female. The age mean was 16.22±16.36. 17(73.92%) patients were classified as having relapsing-remitting MS, while 5 patients (21.73%) were classified as having secondary progressive MS and 1 patient (4.35%) was classified as having primary progressive MS. There were no significant differences in clinical and epidemiological features for MS subtypes in the institute. 12.9% of patients had positive family history for the disease and one patient had a benign MS. The clinical and epidemiological features of early and adult onset MS were not significantly different in the study. Conclusion: The present study confirmed that while the clinical and epidemiological features of MS patients in Hamedan university hospital were similar to those in other Iranian institutes in most of the cases, early onset MS was more common.

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Background : Healthy Life for Cardiovascular Patients(HLCP), one of the ten projects included in Isfahan Healthy Heart Program, was designed and performed based on high-risk and secondary prevention strategies and aimed to reduce cardiac recurrences, along with the risk factors, morbidity and mortality among cardiovascular patients. In this study we investigate the trend of changes of frequency of coronary patients’ medicine intake, aswell as the results of process evaluation. Materials and Methods: Five main strategies were designed to meet the project's goals. These interventions were designed based on education, legislation, and attracting inter-division and public cooperation. Process evaluation was performed in order to determine the project's successfulness. Prior to the project, the morbidity and medicine intake among the patients were also studied. These indices were again measured during the interventions and also after the project were completed. Results: Amongst all the interventions, educating the patients during the hospitalization period, at the time of release and also post-release educations were successful. Another success of the project in merging secondary prevention programs in the society was to attract public coordination and to establish a Non-Governmental Organization. The results also show an increase in the amount of aspirin, beta blockers, Angiotensin Converting Enzyme (ACE) Inhibitors, and statins taken by cardiovascular patients during the project. Conclusion: The results suggest that secondary prevention and cardiovascular patient care promotion interventions can be performed using available facilities.

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Background: Given the role educational system, it is necessary to most desirable design and implements activities. Internal evaluation is process in which members of the department said the group's objectives and their performance are judged and then reviewed their role and for better performance, essential steps to take.The purpose of this study was the internal evaluation of Physiology Department of Lorestan University of Medical Sciences.

Materials and Methods: The study was descriptive and cross sectional conclucted in 2014-2015. Data was collected using questionnaire and was evaluated in 6 areas. Questionnaire was prepared and drafted by some faculty members and Medical Education Development Center. Based on the Likert scale, data was classified favorable, relatively favorable and unfavorable in a range of 0 to 5 points.

Results: The results showed that the head of department area (acquired by averaging 4.23), faculty members (3.57), educational courses (3.96) and curriculums of the department of physiology (3.57) are favorable and areas of educational and research requirement and constructions (2.92) and research activities of the faculty members (2.73) are comparatively favorable.

Conclusion: According to Likert scale, department of physiology of Lorestan University of Medical Sciences was evaluated and ranked in all mentioned areas (acquired by averaging 3.39), therefore has a satisfactory level.

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Background: Since the emergency department is considered as a vital and important department of any hospital, so the study of service delivery processes in the emergency department has a significant role in patient satisfaction. The purpose of this study is to identify the factors affecting the performance of the emergency department and determine the existing bottlenecks and provide appropriate strategies to improve performance and reduce patient waiting time using a simulation approach.
Materials and Methods: This research is descriptive-analytical. The statistical population of this study was all patients referred to the emergency department of Khorramabad Nomadic Martyrs Educational and Medical Center in a period of three months, which was performed cross-sectionally on 200 patients. First, the processes of the emergency department were identified and then the time of patients' arrival and the time of providing services of the emergency department processes in a quarterly interval were randomly measured in three shifts of morning, evening and night. Then the current situation was designed and simulated using Arena software. By implementing the simulated model, bottlenecks in the emergency department were identified and 6 scenarios were designed and implemented to clear the bottlenecks, improve emergency performance and reduce patient waiting time, and the results were compared and analyzed.
Results: Based on the output of the simulated model, laboratory processes, patient discharge and ultrasound-radiology processes with an average of 174, 71 and 27 minutes of waiting queue were identified as the main bottlenecks. Based on this, 6 scenarios were designed and implemented in the simulation model. According to the simulation results, scenario F with an average decrease of 1.8 hours had the highest decrease in average waiting time and scenario C with a decrease in waiting time of 0.6 hours had the lowest decrease in average patient waiting time compared to other scenarios. Also, Scenario B had the lowest and Scenario F had the highest patient output compared to other scenarios. However, scenario C, which had the least decrease in patient waiting time, has an increase of 11.67% in patient output compared to the current situation.
Conclusion: Scenario F, E and A have better results than other scenarios, respectively, and due to resource and cost constraints in scenarios F and E, the implementation of Scenario A (adding 2 laboratory experts) leads to a reduction in the average waiting time of patients for 1.43 hours compared to the current situation, is recommended.