The nursing process is defined as a standard of care; however, its implementation in actual clinical settings is very limited, which reduces the quality of care.Objective: To determine the barriers to the implementation of the nursing process from the viewpoint of the faculty members, nursing managers, nurses, and nursing students of the Mashhad University of Medical Sciences. Materials and Methods:This analytical cross-sectional study was carried out in 2014 on 90 nursing lecturers and students of the Mashhad Nursing and Midwifery Faculty, and 134 nurses and nursing managers of the educational hospitals of the Mashhad University of Medical Sciences. The participants were selected by the convenient sampling method using a research-oriented questionnaire (validity and reliability confirmed) to investigate the barriers to the implementation of the nursing process. The data was analyzed by using descriptive statistics (mean±SD, and absolute and relative frequencies), one-way ANOVA, and the Pearson correlation coefficient. Results:The most significant barrier to implementing the nursing process according to 90% of the lecturers was the lack of a checklist for recording the process in the medical records of the patients; according to 90% of the managers, it was the high number of patients under care of each nurse, and according to 90% of the nurses and 93.5% of the students, it was the lack of a principal training of the nursing process during their studentship. There was a significant difference in the views of the four groups (P=0.03). Conclusion:The health system authorities of the country should make changes in the clinical and educational areas, such as including a nursing process record sheet in the medical records of the patients, getting advice and assistance from the experts in the field of nursing education and technology, and facilitating the implementation of the nursing process in the clinical field.
Background: Patient education is one of the most basic patient rights. It has multiple benefits including decreased patient anxiety, increased patient adherence to treatment programs, and ultimately improvement of healthcare service quality. Patients, especially those with chronic conditions, make daily decisions about illness self-management. Given the nature of their professions, physicians and nurses have more responsibility regarding patient education. Objectives: This study compared patient's satisfaction with educational performance of physicians to that of nurses at Mashhad University of Medical Sciences. Patients and Methods:This descriptive cross-sectional study was performed in 2013 with 231 patients hospitalized in Mashhad-based hospitals affiliated with Mashhad University of Medical Sciences. Sampling was performed nonrandomly using quota sampling. Data collection tools were a demographic information questionnaire and separate questionnaires for satisfaction with educational performance of physicians and nurses. Data were analyzed in SPSS (11.5) using t-and Wilcoxon's tests. Results: There were 231 participants (men: 55.3%). Of them, 58.9% of the patients were satisfied with educational performance of nurses and 50.6% were satisfied with that of physicians. To compare satisfaction with physicians' (66.2 ± 23.4) and nurses' (74.1 ± 24.1) educational performances, mean total satisfaction points out of 100 were obtained. Independent t-test showed a significant difference in this regard (P = 0.02). Conclusions: Nurses and physicians' educational roles should be examined in the authors' healthcare system. Further surveys are needed to find and assess individual and organizational approaches to improve physicians' and nurses' educational performances.
Background and Aim: Quality of care in the health system is one of the most important issues and one of the most important indicators in organizational accreditation. Use of managerial principles, such as the division of labor among nurses, can affect the quality of care. Materials and Methods: This was a randomized double-blind clinical trial which included 44 nurses and 59 patients in 4 CCU wards. The intervention included 3 sessions of 2-hour workshops and then implementing the two above-mentioned care methods for the patients. After the intervention and at the time of discharge, the quality of care provided was assessed from the patients' point of view by means of quality care patient scale. Data were analyzed by Mann-Whitney test. Results: The results showed after the intervention, the mean values for general quality of patient care in the primary group and case method group were (14.2 ± 1.9) and (11.2 ± 2.8) respectively. Also the quality of professional care in the primary group and case method group were (18.2 ± 2.2) and (3.5 ± 14.2) respectively. Mann-Whitney test in both aspects showed that the quality of general and professional care was significantly higher in the primary group than in the case-method group (p <0.05). Conclusion:The results of this study indicated that the primary method can be used in some wards, and was more effective than the case-method. Therefore, paying more attention to nursing care management planning is recommended.
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