Head nurses' performance plays an important role in the successful operation of hospitals. Identification and prioritisation of managerial competencies required for these supervisors and evaluation of their performance on this basis are necessary. This study aimed to provide a valid tool for assessing managerial competencies of hospital department head nurses. First, through literature review, Delphi technique and expert panel, a competency model was developed. Then using the analytic hierarchy process, competencies were weighted and prioritised. Finally, based on the model, an instrument was designed to measure the competencies of head nurses. Validity and reliability of the instrument was also checked. The proposed framework included 27 competencies categorised by four main managerial tasks: planning, organising, leadership and control. Findings revealed that the highest priority was given to strategic thinking (0.1221) and the lowest priority was given to evidence-based decision making (0.007). Based on impact score and content validity ratio results, the content validity of all questions has been proved. Furthermore through the use of a content validity index, 11 questions were omitted or modified. The study presents a valid and comprehensive model for assessing managerial competencies of hospital department head nurses in order to take an important step towards improving their performance.
Background: The COVID-19 pandemic and the increased workload and stress associated with the disease prevalence have posed a high risk of burnout to nurses. The effects of the workplace and environmental factors on resilience and burnout among nursing professionals have not been investigated in Iran. Objective: Present study aimed to assess a model linking quality of work-life to the resilience and various dimensions of burnout among Iranian nursing professionals based on the health service workplace environmental resilience model. Methods: This was a cross-sectional study performed on 202 Iranian nurses employed in three educational hospitals. Maslach burnout inventory, Brooks’ quality of nursing work-life survey, and an abbreviated version of the Connor-Davidson resilience scale were used to collect data. The correlation between the study variables was assessed by conducting path analysis in AMOS 22. Results: The final model demonstrated adequate fit. The quality of working life indirectly affected burnout via a direct impact on nursing professionals’ resilience (p <0.001, β = 0.39). In addition, resilience had negative, significant effects on all the dimensions of job burnout. The quality of work-life also had negative and significant effects on emotional exhaustion (p <0.001, β = -0.38) and reduced personal accomplishment (p <0.001, β = - 0.38). Conclusion: Resilience and quality of work-life are protective variables against burnout in nursing professionals. Nursing managers can increase resilience and decrease burnout among nursing professionals by adopting policies that can improve the quality of work life.
We compared the prognosis of inpatients with a known diagnosis of Alzheimer’s or Parkinson’s disease who have COVID-19 infection with other hospitalized patients with COVID-19. Our cohort study started in October 2020 and ended in May 2021and included inpatients with COVID-19 infection who were admitted to hospitals. From a total of 67871 patients with a confirmed diagnosis of COVID-19, a sample of 3732 individuals were selected of which 363 had Alzheimer’s, and 259 had Parkinson’s disease. All patients had both positive RT-PCR test and positive chest CT for COVID-19. The outcome was dead within 28 days of admission and the predictors were a large number of demographic and clinical features, and comorbidities recorded at patients’ bedside. Mortality were 37.5%, 35.1%, and 29.5% in patients with Alzheimer’s disease, Parkinson’s disease; and in other patients, respectively. The hazard ratio for Alzheimer's disease was 1.27 (95% CI, 1.06–1.53, p =0.010) and for Parkinson’s disease was 1.17 (95% CI, 0.94–1.46, p =0.171). Age was a predictor of mortality, hazard ratio=1.04 (95% CI, 1.03-1.05, p<0.001). Patients with Alzheimer's disease and COVID-19 infection were older and more likely to have a loss of consciousness on admission (both p≤0.001). We concluded that inpatients with Alzheimer’s disease have an increased risk for 28-day mortality from COVID-19 and healthcare settings should be ready to provide critical care for them such as early intubation and immediate O 2 therapy. However, Parkinson’s disease does not significantly predict higher mortality of COVID-19.
Introduction: In the present study, the goal was to estimate the hospital length of stay among patients admitted with COVID-19 in a hospital in Tehran. Methods: We used retrospective data on 446 hospitalized patients with COVID-19 who admitted from 7 March to 8 Oct 2020 in a referral hospital in Tehran, Iran. The prognostic effects of variables, including age, gender, comorbidity status, and symptoms were analyzed by using Kaplan-Meier methods and a competing risk analysis. Length of stay in hospital was calculated using time of last status minus time of admission. All analyses performed using SPSS version 22.0 and STATA version 15. Results: The mean age of cases was 57.09±16.85 years old. The median (IQR) of hospital length of stay among all patients was 7 (11-5) days. The length of Hospital stay, for >80 years’ patients (9days (15-5)) and females (7days (11-5)) was the longest. The most of cases (94 (21.1%)) were in 60–69 age group. In overall 267 (59.9%) of all cases were males and 179 (40.1%) were females. The most common symptom among patients was Respiratory distress 249 (55.8), Cough 233 (52.2) and fever 209 (46.9) respectively. Regarding having any comorbidities, 106 (23.8%) of COVID-19 cases had Cardiovascular disease, 114 (25.6%) had diabetes and 100 (22.4%) had hypertension. Most of deaths (21 (32.3%)) occurred in 70-79 years’ age group. The overall Case Fatality Rate (CFR) in under-studied cases was 14.6%. Conclusion: Although the result of the present study showed that hospital length of stay in Iran is not higher than in other countries, but by applying some measures including the early detection of suspected cases and timely treatment and necessary funding on preparing required facilities, medicine and equipment, it could be shortened or at least prevented from increasing.
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