Identifying mitigation strategies of comprehensive health centers against dust hazard: a qualitative study in Iran.

BACKGROUND: Exposure to dust can disrupt healthcare services and severely affect all activity domains of the health system. The aim of this study was to explore mitigation strategies for comprehensive health centers against dust hazard. METHOD: The present study was conducted using a qualitative design with a conventional content analysis approach in 2023. The participants in this study were managers and staff of comprehensive health centers and experts in health in disasters and emergencies in Kerman, Bam, Regan, and Ahvaz. Data were collected through interviews. Data collection continued until data saturation. The collected data were analyzed based on the steps proposed by Graneheim and Lundman. Participants' statements, after recording and transcribing, were categorized into semantic units. Data were analyzed by using MAXQDA software version 2020. RESULTS: The analysis of the data with 23 participants revealed 106 Codes, 13 sub- categories and 5 main categories including: (A) reducing the impact of dust hazards, (B) management functions, (C) empowerment and performance improvement, (D) maintaining and promoting safety, and (E) Inter-sectoral coordination to implement mitigation strategies. CONCLUSION: The findings showed that the mitigation strategies and solutions can be used by health policymakers and planners to reduce the impact of dust hazard, empower and motivate healthcare staff, develop training protocols to enhance risk perception of the staff and members of the community, create the necessary infrastructure for adoption of effective mitigation strategies in healthcare centers to create resilience and continue service delivery.

An Operational Exercise for Disaster Assessment and Emergency Preparedness in South of Iran.

INTRODUCTION: Exercise is an important step in preparation and implementation of disaster risk programs. The aim of this research was the development and assessment of an operational exercise for disaster preparedness in southeast Iran. METHODS: A descriptive cross-sectional study was used to evaluate a 2-day exercise for a level 4 (L-4) scale mock disaster conducted in southeastern Iran in 2017. Seven medical sciences universities participated in the mock disaster exercise: Kerman, Rafsanjan, Bam, Jiroft, Zahedan, Zabol, and Iranshahr medical sciences universities. In total, 990 personnel participated. The disaster preparedness was assessed using a tool designed by the exercise planning team. RESULTS: The present research reveals that the universities of medical sciences in the southeastern hub of Iran are properly prepared for emergencies and disasters. This included the Disaster Medical Assistance Teams and the response operational comprehensive plan for emergencies and disasters. The research findings indicated a preparedness score of 79.8%. The mean arrival time at exercise area (Jiroft City) was 4 hours 35 minutes despite the wide area of Kerman and Sistan and Baluchistan provinces. Personnel safety and security, rapid assessment, communications, logistics, warnings, and news confirmation functions showed higher levels of preparedness. CONCLUSION: The Joint Commission on Accreditation of Healthcare Organizations reported that organizations must perform the performance preparedness exercises on different levels and areas twice a year to be properly prepared for responding to emergencies and disasters. This study can be considered a suitable standard guide for health care organizations to execute exercises for the maintenance and promotion of their preparedness for properly responding to emergencies and disasters at L-4.

Motivation of the nurses in pre-hospital emergency and educational hospitals emergency in the southeast of Iran.

INTRODUCTION: Nurses, as the largest human resource element of health care systems, have a major role in providing ongoing, high-quality care to patients. Therefore, due to the importance of this issue, this study aimed to determine job motivation of the nurses in pre-hospital and educational hospitals emergency in the southeast of Iran. METHODS: In this study, a cross-sectional method was used, and it was conducted in educational hospitals and pre-hospital emergencies under supervision of the Kerman University of Medical Sciences in 2017. Using a valid and reliable questionnaire, we assessed job motivation of the nurses using a census method (N = 275). Data were analyzed by implementing descriptive statistics including mean and standard deviation (SD), and analytical statistics such as Kolmogorov-Smirnov, ANOVA, t-test, X2, Pearson, and multivariate regression tests using SPSS 16 and P ≤ 0.05. RESULTS: Among the pre-hospital emergency nurses, the average of the educational factors was 25.33, financial factors was 6.34, psychological factors was 20.07, welfare factors was 0.63, and administrative factors was 8.16. Among the nurses of the educational hospitals emergency, these factors were 25.33, 6.51, 20.34, 16.55, and 8.39, respectively. Two group's nurses were at the intermediate level of the job motivation. CONCLUSION: Dynamic and predetermined goals of emergency include providing services as soon as possible and stabilizing patient's condition during the golden and vital time of rescue. Findings suggest that national and local policies in Iran may need to examine factors that contribute to the promotion of the motivation as well as focusing on how to improve them.

Identifying and Explaining the Components Affecting for Design Preparedness Exercises of the Health System in Emergencies and Disasters: A Quality Content Analysis.

OBJECTIVE: Running exercise courses in different sectors of the health system is one of the important steps to prepare and deploy disaster risk management programs. The present study aimed to identify and explain the components affecting the design of preparedness exercises of the health system in disasters. METHODS: This study was a qualitative content analysis. Data were collected by purposeful sampling through in-depth and semi-structured individual interviews with 25 health professionals in disasters who had experience in designing, implementing, and evaluating an exercise. The data were analyzed using the content analysis method. RESULTS: The data analysis resulted in the production of 50 initial codes, 12 subcategories, 4 main categories of "Coordination, Command, and Guidance of Exercise," "Hardware and Software Requirements of Exercise," "Organizational Exercise Resources," and "Communication and Exercise Public Information" with the original theme of "Exercise Design." CONCLUSION: This study provides a clear picture and rich, constructive information on the concept of designing health system preparedness exercises in disasters. The findings of this study can greatly increase the attention of senior managers in all areas of health, especially managers of prehospitals and hospitals who are in the front line of the response to disasters to design standard and scientific preparedness exercises.

Response capability of hospitals to an incident caused by mass gatherings in southeast Iran.

BACKGROUND AND OBJECTIVES: Hospitals are expected to provide a safe environment for patients, visitors, and employees during emergencies and disasters, as well as provide health care to disaster survivors. The aim of this study was to evaluate the response capability of hospitals to an incident caused by mass gatherings (MG) in Kerman province. METHODS: This cross-sectional study was performed among hospitals of Kerman city in 2021. To collect data, the emergency response checklist-WHO (2011) was utilized with 90 questions prepared in nine domains. Data analysis was carried out using SPSS version 20 with descriptive tests. RESULTS: In this incident, 438 people were injured and 61 killed (31 women and 30 men). Of the 438 injured taken to hospitals, 193 were treated on an outpatient basis, 146 were hospitalized and 99 were treated at Advanced Medical Post (AMP) and mobile hospital in the scene. Results showed a moderate response level of hospitals to an incidence (151.50±18.28). Among the components of hospitals' response to incidence, the command and control component had the highest mean score (159.16 ± 22.39) while the surge capacity component had the lowest mean score (129.78 ± 25.21). CONCLUSION: Our hospitals faced new challenges in this incident; therefore, policymakers and executives managers of the health system in Iran should develop a comprehensive strategic plan to promote hospitals' preparedness for suitable and timely response to MG incidences and improve risk perception of mass gathering participants and hospitals personnel through training and implementing discussion and operation-based exercises.

Domestic Violence Against Women Working in Four Educational Hospitals in Iran.

Domestic violence is a serious threat to the health of women in the world and derives from several factors. Therefore, due to the importance of this issue, this study aimed to determine domestic violence against women in four educational hospitals in Iran as a Muslim country. The study employed a cross-sectional design and was conducted in four educational hospitals supervised by the Kerman University of Medical Sciences in 2016. Using a researcher-made questionnaire, we assessed factors associated with domestic violence in female employees using a census method (N = 400). Data were analyzed using descriptive statistics including mean and SD and analytic statistics such as Kolmogorov-Smirnov, ANOVA, t test, and Pearson and multivariate regression tests using SPSS 16 and p ≤ .05. This study showed that most common types of violence against women are psychological/verbal (58%), physical (29.25%), and sexual (10%), respectively. There was a significant relationship between couples' age gap, forced marriage, husband addiction, income, and history of violence experienced by the husband with domestic violence against women. This study examines the basic prevalence of partner violence victimization among Iranian women who work in hospitals in southeast Iran. Findings suggest that national and local policies in Iran may need to examine factors that contribute to violence against women as well as focusing on how to reduce partner violence.

Crowd Simulations and Determining the Critical Density Point of Emergency Situations.

OBJECTIVE: In modern societies, crowds and mass gatherings are recurrent. A combination of inadequate facilities and inefficient population management can lead to injury and death. Simulating people's behavior in crowds and mass gatherings can assist in the planning and management of gatherings, especially in emergency situations. METHODS: We aimed to determine the crowd pattern and the critical density point in the grand bazaar of Kerman in Iran. We collected data by use of a census method with a questionnaire. To determine the critical density point, height and weight data were placed in the equation $\,s\,{\equals}\,\sqrt {{{L{\vskip -1.5pt \,\,\asterisk\,\,}M} \over {3600}}} $ and the outer body surface of all the individuals in the bazaar was calculated. The crowd was simulated by use of flow-based modeling. Flow rate was determined by using the equation (flow rate=density * speed). By use of SketchUp Pro software (version 8; Trimble, Sunnyvale, CA), the movement of each person and the general flow rate were simulated in the three-dimensional environment of Kerman bazaar. RESULTS: Our findings showed that the population critical density point in Kerman bazaar would be 6112 people. In an accident, the critical density point in Kerman bazaar would be created in about 1 minute 10 seconds after the event. CONCLUSION: It seems necessary to identify and provide solutions for reducing the risk of disasters caused by overcrowding in Kerman bazaar. It is suggested that researchers conduct studies to design safe and secure emergency evacuation of Kerman bazaar as well as proper planning for better and faster access of aid squads to this location. (Disaster Med Public Health Preparedness. 2017;11:674-680).