Background: High level of workload has been identified among stressors of nurses in intensive care units (ICUs). The present study investigated nursing workload and identified its influencing performance obstacles in ICUs. Methods: This cross-sectional study was conducted, in 2013, on 81 nurses working in ICUs in Imam Khomeini Hospital in Tehran, Iran. NASA-TLX was applied for assessment of workload. Moreover, ICUs Performance Obstacles Questionnaire was used to identify performance obstacles associated with ICU nursing. Results: Physical demand (mean=84.17) was perceived as the most important dimensions of workload by nurses. The most critical performance obstacles affecting workload included: difficulty in finding a place to sit down, hectic workplace, disorganized workplace, poor-conditioned equipment, waiting for using a piece of equipment, spending much time seeking for supplies in the central stock, poor quality of medical materials, delay in getting medications, unpredicted problems, disorganized central stock, outpatient surgery, spending much time dealing with family needs, late, inadequate, and useless help from nurse assistants, and ineffective morning rounds (P-value<0.05). Conclusion: Various performance obstacles are correlated with nurses' workload, affirms the significance of nursing work system characteristics. Interventions are recommended based on the results of this study in the work settings of nurses in ICUs.

Introduction: Hospital beds, human resources, and medical equipment are the costliest elements in the health system and play an essential role at the time of treatment. In this paper, different phases of the NEDA 2026 project and its methodological approach were presented and its formulation process was analysed using the Kingdon model of policymaking. Methods: Iran Health Roadmap (NEDA 2026) project started in March 2016 and ended in March 2017. The main components of this project were hospital beds, clinical human resources, specialist personnel, capital medical equipment, laboratory facilities, emergency services, and service delivery model. Kingdon model of policymaking was used to evaluate NEDA 2026 development and implementation. In this study, all activities to accomplish each step in the Kingdon model was described. Results: The followings were done to accomplish the goals of each step: collecting experts’ viewpoint (problem identification and definition), systematic review of the literature, analysis of previous experiences, stakeholder analysis, economic analysis, and feasibility study (solution appropriateness analysis), three-round Delphi survey (policy survey and scrutinization), and intersectoral and interasectoral agreement (policy legislation). Conclusion: In the provision of an efficient health service, various components affect each other and the desired outcome, so they need to be considered as parts of an integrated system in developing a roadmap for the health system. Thus, this study demonstrated the cooperation process at different levels of Iran’s health system to formulate a roadmap to provide the necessary resources for the health sector for the next 10 years and to ensure its feasibility using the Kingdon policy framework.

Niosoms are nanoparticles used in drug delivery systems. Niosomes are prepared by various methods. In this research niosoms were prepared by reverse phase evaporation and the factors affecting the niosomes formation were studied. Percent of paclitaxel pegylated and non-pegylated prepared with Span 60 were 95 and 92, respectively while for those of pegylated and non-pegylated niosomes with Span 20, 94 and 90, respectively. In addition, the average diameters of pegylated and no-pegylated prepared with Span 60 and 20 were determined to be 191, 214, 244 and 284 nm, respectively. The amount of released drug (48 h) from pegylated and non pegylated formulations in the presence of Spans 60 and 20 were 8, 10, 6, 7%, respectively. Cytotoxicities ofpaclitaxel niosom polyethyleneglycol, paclitaxel niosome and free paclitaxel on MCF-7 cell line after 48 hours were studied by MTT assay. The results showed the formulation prepared with Span 60 is more effective than that of Span 20 and the IC50 of the former was decreased twice while IC50 of the later decreased 1.5 times.

Objective:Work engagement is a new concept in the field of psychology and human resource management. Increased vitality and enthusiasm is a social phenomenon that brings work engagement for society. This study aimed to evaluate work engagement and its determinants in Kermanshah hospitals’ staff.Methods:This cross-sectional study was conducted on 387 hospital administrative, clinical, paraclinical, and service staff. The sample size was calculated using Krejcei-Morgan table. The data were collected using a questionnaire including demographic characteristics and job engagement components. Then, the data were analyzed using descriptive statistics as well as independent sample t-test and one-way ANOVA.Results:The participants’ mean (SD) of age was 32.63±2.7 years and most of them were female (57.6%). The results revealed a significant relationship between work engagement and age group (P=0.01) and work experience (P=0.04). However, no significant relationship was found between work engagement and sex, education level, and job unit.Conclusion:The results of this study showed that only job experience and age were associated with work engagement. However, no significant relationship was found between work engagement and education level, sex, and job. Thus, further studies are suggested to investigate the cultural factors and personality traits associated with job enthusiasm among the hospital staff, especially nurses.

Background: Hospital infections have affected millions of people around the world and are considered as one of the most important issues related to patient safety. Therefore, this study was conducted to estimate the extra costs caused by hospital-acquired infections in hospitals. Methods: This retrospective cohort study was conducted in Tehran province, Iran, in 2017. Medical records of 235 patients hospitalized in one of Tehran hospitals were reviewed for the study. They were divided into case (90 patients) and control (145 patients) groups. Data were analyzed using SPSS and STATA software. Results: Results revealed no significant relationship between age and gender with the incidence of nosocomial infection (p>0.05). However, the chance of nosocomial infection is most affected by length of hospital stay and costs paid by patients. Moreover, nosocomial infection increases the length of hospital stay up to 25 days. Our results revealed that the mean±SD hospital stay of infected and non-infected patients were 15.8±17.2 and 40.8±19.1 days, respectively. Furthermore, the total cost of patients without any hospital infection was 2451±3098 USD (83 674 480±105 765 500 Rials). On the other hand, the cost for infected patients was 3264±6078 USD (207 497 500±111 430 700 Rials). Conclusion: Hospital-acquired infections can impose great costs on both patients and the health system. The results of this study indicated the importance of taking specific measures for infection control in hospitals.