Prevalence of Needlestick Injuries among Iranian Nurses: A Systematic Review and Meta Analysis.

Background: Injuries caused by sharp objects are a major health risk for nurses. These injuries can be extremely dangerous and lead to various diseases. The purpose of this study was to establish the pooled prevalence of Needle Stick Injuries (NSIs) among nurses in Iran. Materials and Methods: This study was a systematic review and meta-analysis. Eligible articles were searched from five electronic databases (Scientific Information Database (SID), Magiran, Web of Science, PubMed, and Scopus) and one search engine. A random effects model was conducted to estimate the pooled prevalence. The heterogeneity of the sample was tested using the I2 index, and the meta-regression function was used to evaluate variables suspected of heterogeneity at the 0.05 significance level. Finally, 21 articles were analyzed using the Comprehensive Meta-Analysis software (ver. 2.2.064). Results: Based on the random-effects model, the frequency of NSIs among Iranian nurses is 18.70% (95% CI: 15.10%-22.90%). The highest frequency is recorded in a teaching hospital in Tehran in 2007 (19.80%; 95% CI: 16.40%-23.70%), and the lowest frequency was recorded in a teaching hospital in Tehran in 2008 (17.90%; 95% CI: 14.60%-21.80%). Sample size, mean age, and work experience were significantly associated with and mean and frequency of NSIs in nurses (p < 0.05). Conclusions: NSIs occur in about one-fifth of nurses in Iranian hospitals. In addition to its cost burden, the increase in NSIs has negative consequences for nurses. Therefore, health policymakers and managers must take serious action to reduce these injuries.

Prevalence of hospital-acquired pressure injuries in intensive care units of the Eastern Mediterranean region: a systematic review and meta-analysis.

BACKGROUND: Hospital-acquired pressure injuries are a major patient safety concern in intensive care units that are considered largely preventable adverse events by adherence to nursing standards of care. The hypothesis of this research was to investigate the prevalence of hospital-acquired pressure injuries in intensive care units (ICUs) of the Eastern Mediterranean Region. METHODS: This study was designed as a systematic review and meta-analysis. All articles published on Pressure ulcer prevalence in the ICUs of hospitals in Eastern Mediterranean Region countries, identified by searching PubMed through MEDLINE, Web of Science, Scopus, and Google Scholar from January 1, 2011, until September 22, 2023. The reference lists of these articles were checked for additional relevant studies. Data were analyzed using the Comprehensive Meta-Analysis Software (v.2.2.064). RESULTS: A total of 15 articles met the inclusion criteria. Based on the random-effects model, the overall Pressure ulcer prevalence rate was 16.6% (95% CI (8.6-29.6)). Both the highest and lowest prevalence was observed in Jordan in 2011 at 83.1% (95% CI (71.2- 90.7)) and in 2012 at 0.9% (95% CI (0.5- 1.5)), respectively. The results showed that publication year, average age, and sample size were the main causes of heterogeneity between the reviewed studies (p < 0.05). CONCLUSION: This systematic review and meta-analysis of the pertinent peer-reviewed literature revealed a high prevalence of hospital-acquired pressure injuries of 16% in intensive care units of Eastern Mediterranean region. Therefore, it is necessary for health policymakers and managers in Eastern Mediterranean Region to take necessary measures to prevent the incidence of Pressure ulcers in hospitals, especially in ICUs.

Prevalence of hospital-acquired pressure injuries in intensive care units of the Eastern Mediterranean region: a systematic review and meta-analysis.

BACKGROUND: Hospital-acquired pressure injuries are a major patient safety concern in intensive care units that are considered largely preventable adverse events by adherence to nursing standards of care. The hypothesis of this research was to investigate the prevalence of hospital-acquired pressure injuries in intensive care units (ICUs) of the Eastern Mediterranean Region. METHODS: This study was designed as a systematic review and meta-analysis. All articles published on Pressure ulcer prevalence in the ICUs of hospitals in Eastern Mediterranean Region countries, identified by searching PubMed through MEDLINE, Web of Science, Scopus, and Google Scholar from January 1, 2011, until September 22, 2023. The reference lists of these articles were checked for additional relevant studies. Data were analyzed using the Comprehensive Meta-Analysis Software (v.2.2.064). RESULTS: A total of 15 articles met the inclusion criteria. Based on the random-effects model, the overall Pressure ulcer prevalence rate was 16.6% (95% CI (8.6-29.6)). Both the highest and lowest prevalence was observed in Jordan in 2011 at 83.1% (95% CI (71.2- 90.7)) and in 2012 at 0.9% (95% CI (0.5- 1.5)), respectively. The results showed that publication year, average age, and sample size were the main causes of heterogeneity between the reviewed studies (p < 0.05). CONCLUSION: This systematic review and meta-analysis of the pertinent peer-reviewed literature revealed a high prevalence of hospital-acquired pressure injuries of 16% in intensive care units of Eastern Mediterranean region. Therefore, it is necessary for health policymakers and managers in Eastern Mediterranean Region to take necessary measures to prevent the incidence of Pressure ulcers in hospitals, especially in ICUs.

Strategies to strengthen a climate-resilient health system: a scoping review.

BACKGROUND: Climate change is a major global threat to human health and puts tremendous pressure on health systems. Therefore, a resilient health system is crucial to enhance, maintain, and restore the population's health. This study aimed to identify interventions and actions to strengthen a climate-resilient health system to deal with the adverse health effects of climate change. METHOD: This study was a scoping review. Five databases and Google Scholar search engine were searched using relevant keywords. Initially, 4945 documents were identified, and 105 were included in the review. Content thematic analysis method was applied using MAXQDA 10 software. RESULTS: Overall, 87 actions were identified for building a climate-resilient health system and were classified into six themes (i.e., governance and leadership; financing; health workforce; essential medical products and technologies; health information systems; and service delivery). The most commonly reported actions were formulating a national health and climate change adaptation plan, developing plans for essential services (electricity, heating, cooling, ventilation, and water supply), assessing the vulnerabilities and capacities of the health system, and enhancing surveillance systems targeting climate-sensitive diseases and their risk sources. CONCLUSIONS: A holistic and systemic approach is needed to build a climate-resilient health system owing to its complex adaptive nature. Strong governance and leadership, raising public awareness, strategic resource allocation, climate change mitigation, emergency preparedness, robust health services delivery, and supporting research, are essential to building a climate-resilient health system.

Strategies to tackle non-communicable diseases in Afghanistan: A scoping review.

Non-communicable diseases (NCDs) and their risk factors are the leading cause of death worldwide and contribute to 74.3% of deaths globally in 2019. The burden of NCDs is escalating in Afghanistan. Currently, every seconds, people in Afghanistan are dying of NCDs. Addressing this challenge in Afghanistan needs effective and practical interventions. This study aimed to identify the strategies developed and implemented in countries with low non-communicable premature death. To conduct a scoping review, we followed the six-step Arksey and O'Malley protocol and searched for eligible articles on eight international databases and the gray literature. The study followed the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines. The inclusion criteria were English documents and evidence produced up to 30 November 2021 for the control of NCDs. We excluded incomplete texts, duplicates, and dissertations due to lack of access. We used EndNote X9 and MaxQDA software for data management and analysis. We conducted content analysis for this study. A total of 122 documents developed between 1984 and 2021 met the inclusion criteria. We identified 35 strategies from which the most used strategies were related to unhealthy diets and smoking cessation programs. Canada (26.4%), Korea (19.8%), and the United Kingdom (19%) have the most publications on the control and prevention of NCDs among the countries included in the study. Most strategies were implemented over 2 years (41%). This study recommends specific interventions to control and prevent NCDs for the main risk factors of tobacco use, unhealthy diet, physical inactivity, and the main non-communicable diseases such as heart diseases, cancers, diabetes, and chronic obstructive pulmonary diseases. Afghanistan Ministry of Public Health, the WHO country office, and other involved stakeholders can use the findings of this review to design and implement strategies for controlling and preventing NCDs in Afghanistan. International organizations such as the World Health Organization, United Nations Agencies, the World Bank, and other involving communities should invest in strengthening good health governance in Afghanistan. The Afghan Government should focus on promoting and funding health literacy among the public and self-care to control and prevent NCDs.

Hospital efficiency in the eastern mediterranean region: A systematic review and meta-analysis.

Background: Recent rising costs and shortages of healthcare resources make it necessary to address the issue of hospital efficiency. Increasing the efficiency of hospitals can result in the better and more sustainable achievement of their organizational goals. Objective: The purpose of this research is to examine hospital efficiency in the Eastern Mediterranean Region (EMR) using data envelopment analysis (DEA). Methods: This study is a systematic review and meta-analysis of all articles published on hospital efficiency in Eastern Mediterranean countries between January 1999 and September 2020, identified by searching PubMed through MEDLINE, Web of Science, Scopus, Science Direct, and Google Scholar. The reference lists of these articles were checked for additional relevant studies. Finally, 37 articles were selected, and data were analyzed through Comprehensive Meta-Analysis Software (v.2.2.064). Results: Using the random-effects model, the mean hospital efficiency in Eastern Mediterranean hospitals was 0.882 ± 0.01 at 95% CI. Technical efficiency (TE) was higher in some countries such as Iraq (0.976 ± 0.035), Oman (0.926 ± 0.032), and Iran (0.921 ±0.012). A significant statistical correlation was observed between the hospital efficiency and the year of publication and sample size (p < 0.05). Conclusion: Efficiency plays a significant role in hospital growth and development. Therefore, it is important for healthcare managers and policymakers in the EMR to identify the causes of inefficiency, improve TE, and develop cost-effective strategies.

Predicting Covid-19 preventive behaviors based on constructs of health belief model.

INTRODUCTION AND OBJECTIVE: The prevalence of Covid-19 has become a clinical threat worldwide. However, knowledge about this new virus is limited. Therefore, this study was conducted to determine the preventive behaviors of Covid-19 based on the constructs of health belief model (HBM) in the clients of health centers in Zabol, Iran. METHODS: This descriptive-analytical (cross-sectional) study was performed on 160 people referring to health centers in Zabol by the available method. A researcher-made questionnaire was used to collect data. Data were analyzed using SPSS20 software and appropriate statistical tests. RESULTS: A positive and significant correlation was observed between preventive behaviors of Covid-19 and perceived benefit constructs (r = 0.29, P = 0.0001) and self-efficacy (r = 0.39, P = 0.0001). HBM constructs were able to predict about 36% of the variance of Covid-19 disease preventive behaviors, with self-efficacy (B = 0.134) being the strongest predictor. CONCLUSION: Since no specific and definitive treatment for Corona has been found yet, taking preventive measures can be the best way to prevent the spread of this disease in the community. Therefore, this can be achieved by raising awareness and preventive behaviors through health education.

The main factors of supplier-induced demand in health care: A qualitative study.

BACKGROUND: Induced demand is a major challenge for financing health promotion, whereby providers exploit patients' information gap to manipulate their demand for health care. The purpose of this study was to identify the factors associated with induced demand for health-care services in hospitals affiliated with Iran University of Medical Sciences (IUMS) in 2018. MATERIALS AND METHODS: In this qualitative study, semi-structured interviews were conducted with 20 participants from IUMS hospitals, including faculty members, physicians, public hospital managers, patients, and researchers with academic and practical experience. Inductive content analysis was used to analyze the data. RESULTS: Overall, 24 subthemes or factors were identified and classified into the health system, the insurer, health-care provider, and health-care recipient themes. Poor monitoring and control, the fee-for-service payment system, limited role of insurance companies, insufficient monitoring of insurance companies, the educational nature of our health centers, health-care providers' interests, and patients' information gap were some important factors in induced demand for health-care services. CONCLUSION: Our results showed that there are many factors that contribute to induced demand for health care. Given the four levels of factors identified in this study, health policymakers and managers must develop strategies at each level to reduce induced demand for health care.

Prevalence of Severe Depression in Iranian Women with Breast Cancer: A Meta-Analysis.

BACKGROUND: Breast cancer is one of the most common cancers in women and has mental and emotional effects, which lead to a decline in their quality of life. This study is aimed at determining the prevalence of severe depression in Iranian women with breast cancer. METHODS: This meta-analysis study was conducted at Zabol University of Medical Sciences in 2019. Seven electronic databases were searched and evaluated for original research papers published on the prevalence of severe depression in Iranian women with breast cancer. Finally, 13 articles were selected and analyzed via Comprehensive Meta-Analysis software. RESULTS: Overall, the prevalence of severe depression in Iranian women with breast cancer was 11% (95% CI (7.2, 16.5)). The highest prevalence was 44% in Tehran City in 2015 (95% CI (31, 57.9)), and the lowest prevalence was 0.8% in Qom City in 2017 (95% CI (0.01, 6.2)). A significant statistical correlation was observed between the prevalence of severe depression and sample size (p < 0.05). CONCLUSION: According to the results of this study, the prevalence of severe depression affects more than one-tenth of women with breast cancer.

Correction to: A systematic review on hospital inefficiency in the Eastern Mediterranean Region: sources and solutions.

In the original publication of this article [1], one author's name needs to be revised from Pavaneh Isfahani to Parvaneh Isfahani.

A systematic review on hospital inefficiency in the Eastern Mediterranean Region: sources and solutions.

BACKGROUND: Evaluating hospital efficiency is a process to optimize resource utilization and allocation. This is vital due to hospitals being the largest financial cost in a health system. To limit avoidable uses of hospital resources, it is important to identify the sources of hospital inefficiencies and to put in place measures towards their reduction and elimination. Thus, the purpose of this research is to examine the sources of hospital inefficiency in the Eastern Mediterranean Region, and existing strategies tackling this issue. METHODS: In this study, the electronic databases MEDLINE (via PubMed), Web of Science, Embase, Google, Google Scholar, and reference lists of selected articles, were explored. Studies on inefficiency, sources of inefficiency, and strategies for inefficiency reduction in the Eastern Mediterranean region hospitals, published between January 1999 and May 2018, were identified. A total of 1466 articles were selected using the initial criteria. After further reviews based on the inclusion and exclusion criteria, 56 studies were eligible for this study. The chosen studies were conducted in Iran (n = 35), Saudi Arabia (n = 5), Tunisia (n = 5), Jordan (n = 4), Pakistan (n = 2), the United Arab Emirates, Palestine, Iraq, Oman, and Afghanistan (n = 1 each). These studies were analyzed using content analysis in MAXQDA 10. RESULTS: The analysis showed that approximately 41% of studies used data envelopment analysis (DEA) to measure hospital efficiency. Sources of hospital inefficiency were divided into four categories for analysis: Hospital products and services, hospital workforce, hospital services delivery, and hospital system leakages. CONCLUSION: This study has revealed some sources of inefficiency in the Eastern Mediterranean Region hospitals. Inefficiencies are thought to originate from excess workforce, excess beds, inappropriate hospital sizes, inappropriate workforce composition, lack of workforce motivation, and inefficient use of health system inputs. It is suggested that health policymakers and managers use this evidence to develop appropriate strategies towards the reduction of hospital inefficiency.

Study of the avoidable mortality in iran: kerman province.

BACKGROUND: Recognizing mortality pattern and observing its trend will help us in determining health priorities, allocating health resources and priorities in health section, eliminating main factors of premature deaths and carrying out epidemiological research. OBJECTIVE: The aim of this research was to determine avoidable mortality in Kerman province. MATERIALS AND METHODS: The present study was carried out longitudinal. A checklist was applied for data collection. Avoidable mortalities were examined in Kerman province between 2004 and 2010. Statistical universe of this research was all deaths registered in statistical unit of health deputy of Kerman University of Medical Sciences; they were all studied through a census method. Data analysis was carried out using descriptive and analytical test by SPSS18.0. RESULTS: Two thousand and one hundred -ninety seven deaths were examined. Of them, 210 deaths were unavoidable and 19987 were avoidable. In this study, most unavoidable deaths were due to pancreases cancer and ovary cancer. CONCLUSIONS: Relative high number of avoidable deaths indicates that performance of health system was not desirable in Kerman during the studied years. Examining trend of avoidable deaths showed that these mortalities are increasing although it is not significant nowadays. However, if this trend continues, it will be very alarming for health care authorities in this region.