Fall-related hospitalization of patients in Iran.

PURPOSE: Trauma has been called the neglected disease of modern society. According to WHO, fall is the second major cause of trauma or deaths resulting from unintentional accidents. The aim of this study was to investigate the different types of fall according to International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) in hospitalized patients visiting specialized accident and trauma hospitals of Mashhad, Iran. METHODS: This was a cross sectional retrospective study performed between March 20, 2013 and March 20, 2014. The research population consisted of all medical records of patients for fall injuries in three specialized accident and trauma hospitals. ICD-10 was adopted to categorize all types of falls (w00-w19). The results obtained were analyzed by SPSS 16. RESULTS: Altogether 7,448 cases were included. The codes w18 (fall on same level) and w09 (fall involving playground equipment) with the frequencies of 1,856 and 1,303, respectively in both genders had the maximum number of falls. The maximum percentage of mortality has been related to "fall on and from ladder"," fall from cliff "and "fall on same level involving ice and snow". CONCLUSION: As falls can cause irrecoverable injuries including mortality of people, thus health authorities and policymakers should take preventive measures given the causes of falls and the root of this type of injuries, so that the costs resulting from this cause and its injuries can be reduced.

Development a national minimum data set for poisoning registry in Iran.

OBJECTIVES: In the developing countries with high mortality rates, poisoning is considered to be one of the most common causes of admission to emergency wards. Given the importance of registering data on poisoned patients, it is very important to have a complete poisoning Minimum Data Set (MDS). Therefore, the purpose of this study was to determine an MDS for poisoning registry in Iran. METHODS: This applied and cross-sectional study was conducted through of Delphi technique in the poisoning ward of Imam Reza Hospital (northeastern Iran) in 2019. Literature reviews were initially carried out on such databases as PubMed, Web of Sciences, Scopus, and Embase. Then, Google search was done to retrieve poisoning forms and poisoning registry websites. Also, we considered International Classification of Diseases, 10th Revision coding guidelines of poisoning. Then, a questionnaire containing data elements of poisoning was developed. RESULTS: In total, 558 data elements were developed during two rounds of Delphi technique. The MDS was divided into 10 categories including patient and communication data, encounter data, diagnostic data and medical history, exposure data, clinical data, treatment data, complications, paraclinical tests, biobank, and discharge data. CONCLUSIONS: Establishing an MDS as the first and most important step towards implementing poisoning registry can be the standard basis for collecting poisoned patient data. The data registered in the poisoning registry can be used for planning, policy-making, prevention, and control purposes.

Online survey software as a data collection tool for medical education: A case study on lesson plan assessment.

Background: There are no general strategies or tools to evaluate daily lesson plans; however, assessments conducted using traditional methods usually include course plans. This study aimed to evaluate the strengths and weaknesses of online survey software in collecting data on education in medical fields and the application of such softwares to evaluate students' views and modification of lesson plans. Methods: After investigating the available online survey software, esurveypro was selected for assessing daily lesson plans. After using the software for one semester, a questionnaire was prepared to assess the advantages and disadvantages of this method and students' views in a cross-sectional study. Results: The majority of the students (51.7%) rated the evaluation of classes per session (lesson plans) using the online survey as useful or very useful. About 51% (n=36) of the students considered this method effective in improving the management of each session, 67.1% (n=47) considered it effective in improving the management of sessions for the next semester, and 51.4% (n=36) said it had a high impact on improving the educational content of subsequent sessions. Finally, 61.4% (n=43) students expressed high and very high levels of satisfaction with using an online survey at each session. Conclusion: The use of online surveys may be appropriate to improve lesson plans and educational planning at different levels. This method can be used for other evaluations and for assessing people's opinions at different levels of an educational system.

Prioritizing factors influencing nurses' satisfaction with hospital information systems: a fuzzy analytic hierarchy process approach.

Our aim was to use the fuzzy analytic hierarchy process approach to prioritize the factors that influence nurses' satisfaction with a hospital information system. First, we reviewed the related literature to identify and select possible factors. Second, we developed an analytic hierarchy process framework with three main factors (quality of services, of systems, and of information) and 22 subfactors. Third, we developed a questionnaire based on pairwise comparisons and invited 10 experienced nurses who were identified through snowball sampling to rate these factors. Finally, we used Chang's fuzzy extent analysis method to compute the weights of these factors and prioritize them. We found that information quality was the most important factor (58%), followed by service quality (22%) and then system quality (19%). In conclusion, although their weights were not similar, all factors were important and should be considered in evaluating nurses' satisfaction.

Occupational exposure to blood and body fluids among prehospital emergency medical services workers in Mashhad, Northeast of Iran.

BACKGROUND: This study aimed to assess occupational exposure to blood and body fluids (BBFs) and the use of protective equipment among prehospital emergency medical services (EMS) workers in Mashhad, Iran. METHODS: This cross-sectional questionnaire survey-based study was conducted from July 2020 to March 2021 in Mashhad. All prehospital EMS workers of Mashhad were invited to participate in the study using the census technique. The questionnaire was about occupational exposure to BBFs, infection control, protective measures, health program, and demographic information. RESULTS: In total, 442 participants answered the questionnaire (response rate: 82.77%). Based on the findings, 420 (95.2%) and 402 (91.2%) participants had been exposed to BBFs as prehospital EMS workers. Moreover, 31.5% and 38.5% of these exposures were caused by contaminated needles and lancets, respectively. The BBFs incidents have occurred despite 98% of the EMS workers reporting there is a needle safety disposable box in the ambulance. The relationship between awareness of precaution measures after exposure to BBFs and training course completion was significant (P < .0001). CONCLUSION: This study demonstrated the high prevalence of occupational exposures to BBFs among prehospital EMS workers. Considering the significant relationship between the completion of standard precautions courses and awareness of BBFs' postexposure measures, it is recommended to consider multi-faceted strategies for continuous monitoring, training, and follow-up of prehospital EMS workers.

Use of Digital Games for Educational Purposes Among Medical and Paramedical Sciences Students, Mashhad, Iran.

This study aimed to investigate the use of digital games for educational purposes among medical and paramedical sciences students at Mashhad University of Medical Sciences (Northeast of Iran). This cross-sectional study was conducted from July 2018 to January 2019. The research population was all students of the school of medicine and school of paramedical sciences at Mashhad University of Medical Sciences (n = 496). The research tool was a researcher-made questionnaire based on a literature review. The validity of the questionnaire was confirmed by its content validity, and the reliability of the questionnaire was evaluated based on the test-retest method (r = 0.82). In this examination of medical and paramedical sciences students' attitudes and perspectives, some novel preliminary insights into the applications, advantages, disadvantages, and features of digital games in education emerge. Overall, the findings showed that the use of interactive digital games can increase students' motivation for learning and make the learning process more attractive for students. This study was approved by the ethical committee of MUMS (approval number IR.MUMS.REC.1397.151).

Attitudes, knowledge, and skills towards artificial intelligence among healthcare students: A systematic review.

Background and Aims: This systematic review examined healthcare students' attitudes, knowledge, and skill in Artificial Intelligence (AI). Methods: On August 3, 2022, studies were retrieved from the PubMed, Embase, Scopus, and Web of Science databases. Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations were followed. We included cross-sectional studies that examined healthcare students' knowledge, attitudes, skills, and perceptions of AI in this review. Using the eligibility requirements as a guide, titles and abstracts were screened. Complete texts were then retrieved and independently reviewed per the eligibility requirements. To collect data, a standardized form was used. Results: Of the 38 included studies, 29 (76%) of healthcare students had a positive and promising attitude towards AI in the clinical profession and its use in he future; however, in nine of the studies (24%), students considered AI a threat to healthcare fields and had a negative attitude towards it. Furthermore, 26 studies evaluated the knowledge of healthcare students about AI. Among these, 18 studies evaluated the level of student knowledge as low (50%). On the other hand, in six of the studies, students' high knowledge of AI was reported, and two of the studies reported average student general knowledge (almost 50%). Of the six studies, four (67%) of the students had very low skills, so they stated that they had never worked with AI. Conclusion: Evidence from this review shows that healthcare students had a positive and promising attitude towards AI in medicine; however, most students had low knowledge and limited skills in working with AI. Face-to-face instruction, training manuals, and detailed instructions are therefore crucial for implementing and comprehending how AI technology works and raising students' knowledge of the advantages of AI.

The trend of normal vaginal delivery and cesarean sections before and after implementing the health system transformation plan based on ICD-10 in the northeast of Iran: A cross-sectional study.

Background and Aims: Concerning the growing rate of cesarean sections (CSs) worldwide, encouraging normal vaginal deliveries (NVDs) and mitigating CS rates is a necessity. This study investigated the status of delivery in hospitals affiliated with the Mashhad University of Medical Sciences (MUMS) before and after implementing health system transformation plan (HSTP). Methods: A cross-sectional study was conducted in 2017 in the obstetrics and gynecology ward in four MUMS teaching hospitals. Data were extracted from hospital information systems (HISs) based on the International Classification of Diseases (ICD-10) and analyzed in SPSS VE10 software. Results: The results revealed a significant difference between the rate of NVDs and CSs before and after HSTP, such that implementing this plan in MUMS hospitals has raised the rate of NVDs by 4%. Except for the age groups of less than 15 and 36-40 years, the difference between NVD and CS was significant in different age groups before and after HSTP. The rate of NVD significantly increased within 2 months after implementing HSTP. Furthermore, the difference in the rate of previous CS before and after implementing HSTP was significant (p < 0.001). Conclusion: The results of this study show the positive impact of the implementation of the HSTP on CS reduction and NVD increase in the studied hospitals. Since the studied hospitals were teaching and concerning the different costs of NVD and CS between the public and private hospitals, it is recommended to study all hospitals with the obstetrics and gynecology ward to precisely assess the success of HSTP in encouraging NVD.

The effect of telerehabilitation on improving the physical activity of patients with osteoarthritis: A systematic review.

This systematic review aimed to evaluate the effect of telerehabilitation on improving physical activity, physical function, and quality of life in patients with osteoarthritis (OA). A systematic review of randomized controlled trial studies was conducted without a time limit by searching for keywords in the title, abstract, and study keywords in the scientific databases Embase, Web of Science, Scopus, and PubMed on October 20, 2021. This study was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Titles and abstracts were retrieved based on the inclusion, exclusion, and quality assessment criteria. Then, full texts were retrieved and reviewed independently by two separate authors based on the eligibility criteria. Disputes were resolved through discussion. A form with the same predefined elements was used to extract data. Totally, eight eligible articles were found through this review. The studies on telerehabilitation approaches were categorized into three categories, which are: home-based exercise programs by online mobile applications, sports counseling and physiotherapist support via telephone calls, and Internet-based exercise training (IBET). In four studies (57%), telerehabilitation was effective in the short term for some months and improved the performance, self-efficacy, and quality of life of participants. On the other hand, in the long-term effects, there was no difference in participants' improvement (43%). In long-term follow-up, there was no difference between the efficiency of traditional rehabilitation and telerehabilitation in improving the physical performance and quality of life. However, telerehabilitation can be a viable alternative to traditional physiotherapy in patients with OA.

Evaluating the Impact of Digital Game on Learning Medical Terminology of Paramedical Students: Protocol for a Randomized Controlled Trial.

This is a study protocol to evaluate the Impact of digital games on learning medical terminology of paramedical students. An unblinded randomized controlled trial (RCT) 2-arm, with 1:1 allocation ratio was randomized by 60 students at the faculty of paramedical science at Mashhad University of Medical Science(MUMS), Iran, who had their medical terminology course at the time of this study, would enter the study. To evaluate the game, Participants in both groups attended typical teaching in traditional instructional activities for two months; however, the intervention group played the smartphone-based digital game during the course. The knowledge level of students in the control and intervention group were measured before and immediately after the intervention using the pre-designed questionnaire. This study was approved by the ethical committee of MUMS (approval number IR.MUMS.REC.1400.336).

Type and Number of Errors of the Iranian Electronic Health Record (SEPAS) in Hospitals Affiliated with Mashhad University of Medical Sciences.

This study aims to identify the type and number of errors in the Iranian Electronic Health Record System (SEPAS) in hospitals affiliated with Mashhad University of Medical Sciences (MUMS). A cross-sectional analytical study was conducted to specify the errors done by SEPAS in the first half of 2019, based on the type and number of errors in 26 hospitals affiliated with MUMS that were connected to the SEPAS system. SEPAS system errors were classified into four categories: identity errors, clinical errors, administrative-financial and technical errors. The most important errors that occurred in the SEPAS system included non-authentication errors in Hospital Information System (HIS), non-service records, and invalid national code, respectively. Therefore, hospital administrators and information system developers must make an effort to prevent such errors.

The trend of top five types of poisonings in hospitalized patients based on ICD-10 in the northeast of Iran during 2012-2018: A cross-sectional study.

Background and Aims: Poisoning remains a major health issue in developing countries with high morbidity and mortality rates; also it is one of the most common causes of admission to hospitals. This study aimed to investigate the trend of the top five types of poisonings in hospitalized patients according to the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) in Imam Reza hospital, Mashhad, Iran. Methods: This was a cross-sectional study performed from March 20, 2012, until September 22, 2018. We collected data from all patients hospitalized for poisoning admitted to the poisoning center at Imam Reza hospital in northeast Iran. ICD-10 was adopted to categorize all types of poisonings (T36-T65). The results obtained were analyzed by SPSS 16. Results: Thirty-four thousand eight hundred and ten cases were included. The mean age of the patients was 29.64 ± 14.69 years, of them, 50.7% were males. Benzodiazepine poisoning (T42.4) has the highest frequency among other subcategories and it was more common among females (60.5%). Opium poisoning (T40.0) has the highest mortality rate (5.4%) among other subcategories that is more common in males (72.0%). The mortality associated with narcotics was the highest frequency (2.7%). Suicide (83.6%) was the most common cause of poisoning. Most poisonings occurred in summer (27.4%). Conclusion: These findings could help health care managers and policymakers develop prevention and educational programs to reduce these poisonings and limit people's easy access to drugs and substances.

Barriers to participation in center-based cardiac rehabilitation programs and patients' attitude toward home-based cardiac rehabilitation programs.

Purpose: The mortality rate of cardiovascular diseases in such developing countries as Iran is on the rise. Despite sufficient evidence pointing to its efficacy, cardiac rehabilitation (CR) approach is only employed to a limited extent. In the present study, barriers to participation in center-based cardiac rehabilitation programs and patients' attitude toward home-based cardiac rehabilitation model were examined. Methods: In this study, 204 eligible patients for CR visiting an academic hospital were examined during the first three months of 2017. Patients had either abandoned rehabilitation programs midway through or had not attended one in the first place. Data about perceived barriers were collected using the modified Cardiac Rehabilitation Barriers Scale. Also, Patients' attitude toward home-based CR was collected using a pre-validated researcher-made questionnaire. Results: The results revealed that the most effective barriers were transportation problems (70%), travel costs (70%), considerable distance to the rehabilitation center (67%), and lack of insurance coverage for rehabilitation costs (64%), respectively. Patients with longer than 30-minute drive time were less likely to attend in training sessions in the center. In addition, the important patient expectations about home-based CR programs included: communication with specialists, training before entering the rehabilitation program, and making periodic visits to maintain motivation and adhere to the home-based CR programs. Conclusions: The results revealed that logistical factors were the major barriers to participation in rehabilitation programs. Alternative models such as home-based CR programs, positively evaluated by the participants, can be used to overcome these barriers.

Evaluating the Students' View of Medical and Paramedical Sciences About Perceived Benefits and Barriers of Virtual Social Networks for Learning Purposes.

Social networks are new technologies that facilitate the sharing and exchange of information and knowledge as well as the communication between students and professors. The purpose of this study was to investigate views of medical and paramedical sciences students about benefits and barriers of virtual social networks for learning purposes. A cross-sectional study was carried out in 2017 and the research tool was a researcher-made questionnaire based on a literature review. The majority of students (medical= 93% and paramedical sciences= 84.7%) tended to use social networks for learning purposes. Also, the results showed that "sending and receiving educational videos" and "sending and receiving educational texts, posts and contents" was the highest priority for medical and paramedical sciences students for using social networks. Overall, the results of our study showed that the social networks can play an effective role in educating medical students and improve students' motivation for learning. However, the use of these technologies also brings problems and challenges.

The Prevalence of Lower Extremity Injuries in Mashhad: A Five-Year Study.

BACKGROUND: Injury is one of the leading causes of death and disability worldwide. Lower extremity injuries put a heavy burden on communities. The aim of this study is to assess the prevalence of lower extremity injuries in Mashhad, Iran. METHODS: The data from 57430 patients with lower extremity injuries from all traumatology hospitals in Mashhad were analyzed in this retrospective descriptive cross-sectional study to determine the prevalence of lower extremity injuries in Mashhad, Iran, between March 2011 and March 2015. RESULTS: The prevalence of lower extremity injury in the general population of Mashhad was 0.34%. The mean age of the casualties was 33.7±19.8 years, and 77.9% were male. Knee and lower leg injuries had the highest frequency (61%). The mean hospitalization period was 7.7±12.6 days. The highest mortality rate (MR) (2%) and discharge against medical advice (DAMA) (11%) were observed in hip and thigh injuries. DAMA (8.8% vs. 6.7%, P<0.001) and MR (1.7% vs. 1.5%, P=0.005) was higher in females. However, males had a longer hospitalization period (8±13) compared to females (6.8±10.1 days) (P<0.001). The prevalence rate was declining during the study period. CONCLUSION: The downward trend of lower extremity injuries is promising; however, the higher mortality rate in females needs more attention. These findings can be used for better management of traumatic patients.

Views of Users Towards the Quality of Picture Archiving and Communication System (PACS) in a Developing Country.

PACS as a medical imaging technology is an information system that provides quick and convenient access to the medical images, as well as the quick and easy exchange of images and electronic reports among specialists in different departments. The objective of the study was to evaluate the PACS from the point of view of users in hospitals affiliated to Mashhad University of Medical Sciences. The study population consisted of the PACS' users (radiologists and the radiology technologists) in the radiology departments (103 staff). Data were collected through a questionnaire that was designed based on previous studies and published literature. From the views of users, quality of information of PACS had the highest average (Mean = 3.57±1.02), while quality of services had the lowest average (Mean = 2.99±0.19). About the quality of information, the highest and lowest averages were dedicated to information security (Mean = 4±0.69) and quality of pictures (Mean = 3.28±0.87), respectively. Generally, the findings of study indicate that there are problems in different parts of PACS quality in Iran and according to the high cost of purchasing, implementation, maintenance, and updating the PACS in hospitals, proper selection and use of software and hardware as well as proper maintenance of the system may lead to not only return on investment but also provision of telemedicine.

Use of Social Networks for Learning Purposes Among Medical and Paramedical Sciences Students, Mashhad, Iran.

Social networking sites are communication and information technologies which can facilitate the interaction between professors and students. The purpose of this study was to investigate the use of social networks for learning purposes among medical and paramedical sciences students in Mashhad University of Medical Sciences (northeastern Iran). A cross-sectional study was carried out in 2017 and the research tool was a researcher-made questionnaire based on a literature review. The results showed that social networks such as Telegram (3.44 ± 1.27 out of 5) and Instagram (1.83 ± 1.17) were the most frequently used social networks. On the other hand, Snapchat (1.04 ± 0.22) and Flickr (1.05 ± 0.31) were the least used social networks for learning purposes. The findings of the study showed that medical students have problems in using social networks for learning purposes. Familiarizing students with scientific and professional social networks such as ResearchGate and Linkedin and creating dedicated social networks, rather than public social networks, designed to achieve educational goals can resolve many problems.

Views of Health Information Management Staff on Non-Technical Security Management Factors, Mashhad, Iran.

Health care organizations are worried about information security because they generate important and valuable information in the field of health informatics. Therefore, the present study was conducted to investigate the health information management staff's viewpoint on non-technical security management factors. A descriptive cross-sectional study was conducted between Feb to Apr 2018 in 12 academic hospitals in Mashhad, north-eastern Iran. Data were collected through a paper-based questionnaire that was designed based on previous studies and published literature. From the views of staff, the information security management had the highest average (Mean = 3.63) while organizational culture had the lowest average (Mean = 3.32). The results of this study showed that security controls are essential for protecting critical information. Organizations must also consider appropriate security actions for protecting critical organizational information.

The Perspective of Nurses on Nursing Information System: A Case Study in a Developing Country.

The purpose of this study was to investigate the effect of nursing information system (NIS) on clinical performance from the perspective of nurses in an academic hospital affiliated to Mashhad University of Medical Sciences in Iran. This descriptive cross-sectional study was conducted in 2016. We collected data targeting nurses with over three years' experience in using the NIS (120 nurses). NIS had caused improvement in "accuracy the consistency of drug, lab tests and radiology requests", "increasing the speed of the automated extracting of minimum data set for decision making and care trends" with the means of 4.89 and 4.27 respectively (5 point Likert). Findings showed that "workload of nurses" (Mean 4.05), "duplication in recording patients' information" (Mean = 3.99) obtained the highest mean. Furthermore, "appropriateness of the data entry tools to tasks" (Mean=3.29) and "the ability of adapting the software to new responsibilities of nurses "(Mean=3.25) gained the lowest mean.

Views of Health Information Management Staff on the Medical Coding Software in Mashhad, Iran.

Systematic evaluation of Health Information Technology (HIT) and users' views leads to the modification and development of these technologies in accordance with their needs. The purpose of this study was to investigate the views of Health Information Management (HIM) staff on the quality of medical coding software. A descriptive cross-sectional study was conducted between May to July 2016 in 26 hospitals (academic and non-academic) in Mashhad, north-eastern Iran. The study population consisted of the chairs of HIM departments and medical coders (58 staff). Data were collected through a valid and reliable questionnaire. The data were analyzed using the SPSS version 16.0. From the views of staff, the advantages of coding software such as reducing coding time had the highest average (Mean=3.82) while cost reduction had the lowest average (Mean =3.20), respectively. Meanwhile, concern about losing job opportunities was the least important disadvantage (15.5%) to the use of coding software. In general, the results of this study showed that coding software in some cases have deficiencies. Designers and developers of health information coding software should pay more attention to technical aspects, in-work reminders, help in deciding on proper codes selection by access coding rules, maintenance services, link to other relevant databases and the possibility of providing brief and detailed reports in different formats.