Developing a framework for the participation of nursing managers in the health policy-making process in Iran: A Delphi study.

AIMS: The aim of this study was to develop a framework for nursing managers to participate in the health policy-making process. BACKGROUND: Nursing managers must be involved in the health policy process to provide appropriate health services, focus on nursing professional excellence, and improve the performance of the health system. METHODS: This multimethod research was based on the Delphi study and experts' panel. Faculty members of the nursing, health policy, health services management, and nursing managers working at hospitals were selected via purposive sampling. The data collection tool was a demographic form and an open-ended questionnaire in the first round and a structured questionnaire in the next round. In the two rounds of Delphi, experts discussed and rated items of nursing managers' participation framework in the health policy-making process. At the expert panel session, the framework was finalized with a 12-part checklist. The data were analysed quantitatively using SPSS software version 22. RESULTS: A total of 28 items were entered into the Delphi study. Experts who met the inclusion criteria responded to rounds 1 (n = 20) and 2 (n = 16). Following the two rounds of the Delphi study, 27 items were selected and discussed by experts using a 12-part checklist related to the framework. The final participation framework was divided into five sections: Barriers, facilitators, advantages, disadvantages, and factors affecting the participation of nursing managers in the health policy-making process. CONCLUSION: In our findings, the relationship between the components of the framework and policy cycle was shown, which should be considered to lay the groundwork for participation. This can lead to health promotion, accountability, and financial participation in the health system, which can improve the proactive involvement of nursing managers in the health policy-making process. IMPLICATIONS FOR NURSING MANAGEMENT: The proposed framework can be utilized across the spectrum of nursing, including practice, leadership, and education to enhance the participation of nursing managers in health policy activity.

Components of contributing conditions to strengthen health system management and leadership capacity building: a systematic review and decision making framework.

PURPOSE: The purpose of this study is to identify components of contributing conditions to strengthen leadership and management capacity in the health system. DESIGN/METHODOLOGY/APPROACH: A systematic search was undertaken in databases including PubMed, Scopus, Web of Science and local resources of Scientific Information Database and Magiran in January 2020. Two independent researchers checked the research process, screening of articles and quality assessment. The quality of the studies was assessed by JBI critical appraisal tools for qualitative studies. The components of the dimensions of health system management and leadership capacity were categorized according to the WHO conceptual framework using a content analysis approach. FINDINGS: A total of 17 articles were included in this study. In total, 16 categories of components include human resource information system (n = 5); criteria, plans and procedures for selection and appointment (n = 5); development of education system (n = 11); skills (n = 39); knowledge (n = 8); attitudes (n = 6); behaviors (n = 10); resource and critical management system (n = 7); performance and processes management (n = 3); operational planning for critical systems (n = 4); establish control systems (n = 2); inputs and outputs of organizations (n = 2); accountability and responsibility to customers and stakeholders (n = 4); legal authority and requirements to play the role of managers (n = 9); external and internal environment management (n = 7); establish a system of appreciation and encouragement (n = 6). Each of these categories also contains subcategories. ORIGINALITY/VALUE: Identifying prerequisite conditions are necessary for building leadership and management capacity in health systems. Therefore, extracted components provide a simple but coherent framework that can be adapted or modified for use in local situations. The components have a variety of uses, including mapping current activities, needs assessment, planning leadership and management development strategies and monitoring and evaluation.

Factors influencing nurses participation in the health policy-making process: a systematic review.

BACKGROUND: Nurses as the majority of the health care workforce help in the health systems strengthening. Nurses' involvement in health policy making is clear; however, still few are involved in policy-making processes, even in the clinical context. The aim of the present systematic review was to identify factors influencing nurses participation in the health policy-making process. METHODS: The present systematic review was designed on studies conducted between 2000 and 2019. Four online databases including PubMed, EMBASE, SCOPUS and Science Direct were searched using comprehensive terms. Study selection, quality assessment, data extraction, and data analysis were independently done by two reviewers. Inclusion criteria included published studies in English language and between 2000 to 2019, participants such as nurses and the healthcare managers, mentioned influential factors, types of participants were included nurses and the healthcare managers, study designs and methods clearly defined. The methodological quality of included article was appraised using the checklists of CASP and MMAT. Finally the data were analyzed using content analysis. RESULTS: After quality assessment, 11 studies, according to inclusion criteria, were retrieved. Nine studies had a good, 2 a medium, and non-articles was poor methodological quality. Three main themes include nursing-related factors (4 sub- themes), management and organizational factors (8 sub-themes) and creating a positive work environment (3 sub-themes) identified as affecting factors on nurses participation in health policy. CONCLUSION: Nurses can utilize this finding to develop empowering programs to play efficient roles and increase their participation in health policy making. Also, the extracted factors in this review can place nurses in suitable position and make them potential agents in changing the ways of policy-making. Further studies are required to survey the relation between these factors and nursing participation in health policy making.

Assessment of medical equipment maintenance management: proposed checklist using Iranian experience.

BACKGROUND: Effective maintenance management of medical equipment is one of the major issues for quality of care, for providing cost-effective health services and for saving scarce resources. This study aimed to develop a comprehensive checklist for assessing the medical equipment maintenance management (MEMM) in the Iranian hospitals. METHODS: This is a multi-methods study. First, data related to factors which affect the assessment of MEMM were collected through a systematic review in PubMed, ProQuest, Scopus, Embase, and web of science without any time limitation until October 2015, updated in June 2017. Then, we investigated these factors affecting using document review and interviews with experts in the Iranian hospitals. In the end, the results of the first and second stages were combined using content analysis and the final checklist was developed in a two-round Delphi. RESULTS: Using a combination of factors extracted from the systematic and qualitative studies, the primary checklist was developed in the form of assessment checklists in seven dimensions. The final checklist includes 7 dimensions and 19 sub-categories: "resources = 3," "quality control = 3," "information bank = 4," "education = 1," "service = 3," "inspection and preventive maintenance = 2" and "design and implementation = 3." CONCLUSIONS: Developing an assessment checklist for MEMM provide a comprehensive framework for the proper implementation of accurate assessment of medical equipment maintenance. This checklist can be used to improve the profitability of health facilities and the reliability of medical equipment. In addition, it is implicated in the decision-making in support of selection, purchase, repair and maintenance of medical equipment, especially for capital equipment managers and medical engineers in hospitals and also for the assessment of this process.