A systematic review of informatics competencies: requirements for nurse managers in healthcare organisations.

Introduction: One vital strategy for the success of healthcare organisations currently resides in the capacity of the nurse managers (NMs) to develop informatics competencies in management. Aim: The aim of this review was to synthesise the evidence related to the informatics competencies of NMs in healthcare settings. Methods: The databases of PubMed, Web of Science, Scopus and Education Resources Information Center were searched. All publications were accepted if they had been published in English and full texts were accessible. The study was carried out using a systematic literature search of work published between January 2000 and December 2021. The Endnote v.17 software was used to facilitate reference management. Quality assessment of publications was carried out independently by two reviewers using the Critical Appraisal Skills Programme guidance. A descriptive summary with data tables was produced to summarise the literature. Results: After screening the search results, 12 studies published between the period 2001 and 2019 met the inclusion criteria. Analysis of the included studies led to the classification of informatics competencies in three main themes: skills related to work with computers (four sub-themes), informatics skills of NMs (three sub-themes) and knowledge of NMs about informatics (five sub-themes). Conclusion: These systematic review results can lead to the identification of informatics competency gaps and recommend and provide solutions to address these gaps and increase competencies for nursing managers.

A systematic review of individual and ecological determinants of maternal mortality in the world based on the income level of countries.

BACKGROUND: This systematic review was conducted to map the literature on all the existing evidence regarding individual and ecological determinants of maternal mortality in the world and to classify them based on the income level of countries. Such a systematic review had not been conducted before. METHODS: We conducted an electronic search for primary and review articles using "Maternal Mortality" and "Determinant" as keywords or MeSH terms in their Title or Abstract, indexed in Scopus, PubMed, and Google with no time or geographical limitation and also hand searching was performed for most relevant journals. STROBE and Glasgow university critical appraisal checklists were used for quality assessment of the included studies. Data of the determinants were extracted and classified into individual or ecological categories based on income level of the countries according to World Bank classification. RESULTS: In this review, 109 original studies and 12 review articles from 33 countries or at global level met the inclusion criteria. Most studies were published after 2013. Most literature studied determinants of low and lower-middle-income countries. The most important individual determinants in low and lower-middle-income countries were location of birth, maternal education, any delays in health services seeking, prenatal care and skilled birth attendance. Household-related determinants in low-income countries included improved water source and sanitation system, region of residence, house condition, wealth of household, and husband education. Additionally, ecological determinants including human resources, access to medical equipment and facilities, total fertility rate, health financing system, country income, poverty rate, governance, education, employment, social protection, gender inequality, and human development index were found to be important contributors in maternal mortality. A few factors were more important in higher-income countries than lower-income countries including parity, IVF births, older mothers, and type of delivery. CONCLUSION: A comprehensive list of factors associated with maternal death was gathered through this systematic review, most of which were related to lower-income countries. It seems that the income level of the countries makes a significant difference in determinants of maternal mortality in the world.

Exploration of knowledge, attitudes, and perceived benefits towards nurse managers' participation in the health policy-making process: a qualitative thematic analysis study.

Background: Participation of nurse managers in policy-making could help policy-makers to propose relevant and effective policies and support other policy actors involved with these processes. Objective: This study aimed at exploring the attitudes and perceived benefits of nurse managers' participation in the health policy-making process. Methods: In this descriptive qualitative research, semi-structured interviews were conducted with 16 nurse managers, government officials, and faculty members. Recruitment was based on purposive sampling from different regions across Iran. A thematic analysis was performed in MAXQDA (version 2012). Results: After analysis of the qualitative data, four themes and 13 sub-themes emerged. The themes were feelings about nurse managers' participation, advantages of nurse managers' participation, problems due to the non-participation of nurse managers, and recommendations for improvement of the policy-making process. Conclusion: The outcomes provided new insights into the perceived benefits of and attitudes towards nurse managers' participation in health policy making in the Iranian setting. It is crucial to strengthen the capacity for nurse managers' participation in health policy making to develop effective healthcare policies.

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.

Application of mobile health to support the elderly during the COVID-19 outbreak: A systematic review.

BACKGROUND: : The COVID-19 outbreak has affected the elderly's physical and mental health. The application of information and communication technology, such as mobile health (m-health), can help control this pandemic by changing the behavior and lifestyle of the elderly during this time of crisis. OBJECTIVE: : This review aimed to synthesize the capabilities of m-health in providing health services to the elderly during the COVID-19 pandemic, and to identify the factors contributing to the success of these tools. METHODS: : To find the relevant studies, a search was conducted in PubMed, Web of Science, Scopus, ProQuest, and Google Scholar. The inclusion criteria were: studies in English that used m-health intervention in all aspects of elderly healthcare during the COVID-19 outbreak, were published in peer-reviewed journals from 31 December 2019, and had any research design and methodology. Two authors independently took all the steps of this review, and finally performed narrative synthesis to report the findings. RESULTS: : Our initial search identified 421 studies, of which 10 met the inclusion criteria. The data analysis showed that all the m-health interventions had positive effects on the health of the elderly. The m-health services for the elderly during the current pandemic were used for therapy, information provision, self-help, monitoring, and mental health consultation purposes. The results also indicated that various factors affected the elderly's use of m-health tools. CONCLUSION: : The application of m-health keeps the elderly and healthcare providers safe, accelerates health service provision, reduces the costs of service provision, and decreases the risk of morbidity and mortality during the COVID-19 outbreak. The successful use of m-health tools for the elderly in health programs during the current crisis greatly depends on supporting the elderly and overcoming the barriers.

The Comparison of China and Iran Response to COVD-19 Pandemic: Lessons Learn for Health Policy.

Currently, despite the change in the course of diseases, attention to infectious diseases and their integration has decreased. The prevalence of remerging infectious diseases has led to the need for appropriate preparation programs. There are still problems in controlling infectious diseases with the outbreak of coronavirus. The outbreak of the disease affected many countries in a short period. Therefore, by examining the actions of the two countries, it is possible to gain appropriate experiences in dealing with infectious diseases. This study was conducted using a gray literature review to examine all applied actions for the response to COVID-19 epidemics and their impacts on the prevalence of this disease in China and Iran. Examination of the documents shows that disease prevention is the most critical action, and we have witnessed a decrease in the number of patients with this disease by the introduction of prevention policies. The implementation problems of quarantine programs were meeting the basic needs of the people and continuing to implement this program. The issue of education was also one of the leading problems.

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.

Telehealth services support community during the COVID-19 outbreak in Iran: Activities of Ministry of Health and Medical Education.

The Coronavirus disease 2019 (COVID-19) outbreak has been ravaging Iran and other countries with increasing morbidity and mortality. The pathogen spread rapidly and the outbreak caused nationwide anxiety and shock in Iran. To combat the COVID-19 epidemic, the Ministry of Health and Medical Education (MOHME) of Iran introduced several policies and activities, including the use of tele-health services. This letter to the editor uses anecdotal and other records to provide a summary of the activities of MOHME during the COVID-19 outbreak in Iran from February 1 to March 31, 2020. In this commentary, we reviewed the MOHME information site and extended the recommendations offered by MOHME via presenting the existing challenges and a roadmap of the necessary policy requirements. The existing evidence demonstrates that tele-health should have been rapidly implemented as it presents an effective mode of service delivery to reduce morbidity and mortality and decrease the burden on healthcare providers and the health system during the COVID-19 outbreak.

Nurses' perception of teamwork and its relationship with the occurrence and reporting of adverse events: A questionnaire survey in teaching hospitals.

AIMS: To identify the levels of teamwork and its relationship with the occurrence and reporting of adverse events among Iranian nurses. BACKGROUND: Strengthening teamwork is emphasized worldwide for enhancing quality care and patient safety. METHODS: This study applied a cross-sectional survey design. A total of 327 Iranian nurses from eight teaching hospitals participated in a self-administered survey using simple random sampling. The Teamwork Perceptions Questionnaire was used to measure the teamwork. The frequency of occurrence and reporting of adverse events were measured with two questions. Data were analysed using descriptive analyses, independent t tests and logistic regression analysis. RESULTS: The mean teamwork score was 3.81 out of 5. Among the nurses, 48.0% had experienced adverse events in the past 6 months and 79.8% reported having an appropriate performance in adverse events reporting. Teamwork was significantly associated with lower occurrences of adverse events and better adverse events reporting. Specifically, nurses with higher situation monitoring (odds ratio (OR) = 0.47), mutual support (OR = 3.18) and team leadership (OR = 2.09) scores were more likely to report adverse events. Nurses with higher situation monitoring scores were less likely to experience the occurrence of adverse events (OR = 0.38). CONCLUSIONS: Nurses' perception of teamwork was moderate to high. Teamwork was associated with the occurrence and reporting of adverse events. Further study is needed to identify the effects of teamwork training on the learning outcomes, including teamwork, occurrence and the reporting of adverse events among nurses. IMPLICATIOS FOR NURSING MANAGEMENT: Nursing managers should consider multiple educational strategies including structured teamwork training to improve staff nurses' teamwork competency. Administrative initiatives and quality improvement projects are needed to increase nurses' performance in the reporting of adverse events through an accreditation process.

The role of telehealth during COVID-19 outbreak: a systematic review based on current evidence.

BACKGROUND: The outbreak of coronavirus disease-19 (COVID-19) is a public health emergency of international concern. Telehealth is an effective option to fight the outbreak of COVID-19. The aim of this systematic review was to identify the role of telehealth services in preventing, diagnosing, treating, and controlling diseases during COVID-19 outbreak. METHODS: This systematic review was conducted through searching five databases including PubMed, Scopus, Embase, Web of Science, and Science Direct. Inclusion criteria included studies clearly defining any use of telehealth services in all aspects of health care during COVID-19 outbreak, published from December 31, 2019, written in English language and published in peer reviewed journals. Two reviewers independently assessed search results, extracted data, and assessed the quality of the included studies. Quality assessment was based on the Critical Appraisal Skills Program (CASP) checklist. Narrative synthesis was undertaken to summarize and report the findings. RESULTS: Eight studies met the inclusion out of the 142 search results. Currently, healthcare providers and patients who are self-isolating, telehealth is certainly appropriate in minimizing the risk of COVID-19 transmission. This solution has the potential to prevent any sort of direct physical contact, provide continuous care to the community, and finally reduce morbidity and mortality in COVID-19 outbreak. CONCLUSIONS: The use of telehealth improves the provision of health services. Therefore, telehealth should be an important tool in caring services while keeping patients and health providers safe during COVID-19 outbreak.