No abstract

Background Electronic Health Records (EHRs) were introduced to all Iranian medical universities in 2015 with the launch of Integrated Electronic Health System (which is known as SIB: a Persian backronym in Persian meaning apple), and a number of studies were conducted on SIB. However, most of these studies did not consider the benefits and challenges of adopting SIB in Iran. Therefore, the present study aimed to identify the benefits and challenges of SIB in health centers of Khuzestan Province, Iran. Methods This was a qualitative study using qualitative conventional content analysis conducted on 6 experts and 24 users of SIB in six health centers of three cities in Khuzestan province, Iran. The participants were selected using a purposeful sampling method. Maximum variation was considered in selecting the group of users, and snowball sampling was used in the group of experts. Data collection tool was semi-structured interview. Data analysis was performed using thematic analysis. Results Overall, 42 components (24 for benefits and 18 for challenges) were extracted from the interviews. Common sub-themes and themes were identified for challenges and benefits. The components formed 12 sub-themes, and they were placed in 3 main themes, namely structure, process and outcome. 1) Structure included four sub-themes of Financial resources, Human resources, Facilities, and Access to the Internet; 2) Process involved three sub-themes of Training, Providing services, and Time and workload; and 3) Outcome incorporated five sub-themes of Quality of health services, Access, Safety and personal distance, Screening and evaluation, and Research. Conclusions In the present study, the benefits and challenges of adopting SIB were examined in three themes: structure, process, and outcome. Most of the identified benefits were related to the theme of outcome, and most of the identified challenges were related to the theme of structure. Based on the identified factors, by strengthening the benefits of SIB and also trying to eliminate or reduce its challenges, it is possible to institutionalize and use it more effectively in order to solve health problems.

No abstract

No abstract

Background: The World Health Organization repeatedly emphasizes the spread and association of nosocomial infections with microbial resistance. In a 2014 report, the World Health Organization cited microbial resistance as a global threat. In recent years, the world has seen the rapid growth of antibiotic-resistant E. coli in most areas, which poses a serious threat to public health. A high percentage of bacteria that cause nosocomial infections have been resistant to treatment. The most common bacterial agent among these nosocomial infections is E. coli. This bacterium is one of the main causes of nosocomial infections among hospitalized patients. One of the most important goals of the Global Antimicrobial Resistance and Use Surveillance System (GLASS) is timely identification and transmission of Emerging Antimicrobial Resistance (EAR) or outbreak of antibiotic resistance. One of the main ways to identify this "emerging" at the national or local level is to identify deviations from the expected resistance in drug compounds. As a result, if the observed cases of a drug-resistant pathogen are significantly higher than expected, it could indicate "emerging".Purpose: This study aimed to identify and transmit EAR or outbreak of antibiotic resistance among antibiotics used in the treatment of nosocomial infections caused by E. coli. This was done by comparing the observed cases of resistant E. coli with the predicted cases of resistant E. coli, which were predicted by the compartment model.Methods: This is a hospital-based study that used data from the nosocomial infection survelliance system to investigate observed cases of antibiotic resistance. In this study, the results of 12,954 antibiogram tests related to 57 hospitals located in 31 provinces of Iran were divided into two parts (results related to the first half of 2017 and results related to the second half of 2017). The model was developed in the second half of the year to predict expected cases. Before developeing model to predict the expected cases of resistant E. coli, the validity of the model was evaluated by implementing the model in the first half of the year. Finally, the predicted cases of resistant E. coli were compared with those observed in 2017. If the difference between the two was statistically significant, it indicated the outbreak of E.coli. This model evaluated 11 antibiotics recommended by the World Health Organization that are used to treat nosocomial infections caused by E. coli.Results: The results of this study showed that the outbreak of E. coli resistant to ampicillin and ceftazidime occurred in 2017 in hospitals of Iran. This means that resistance to ampicillin and ceftazidime antibiotics in nosocomial infections caused by E. coli is higher than expected and has become "emerging".Conclusion: This study showed how the outbreak of antibiotic resistance in the country's hospitals can be investigated. Using the method of this study, we can investigate the outbreak of antibiotic-resistant E. coli in the coming years and in different substrates. The results of this study showed that the administration and use of antibiotics should be reconsidered.