Assessment of antimicrobial drugs employed at government-operated hospitals in central and northern provinces of Iraq.

OBJECTIVE: Aim: To document the clinical patterns of antibiotic prescriptions in government hospitals, where the majority of physicians possess a degree-based training. PATIENTS AND METHODS: Materials and Methods: A Retrospective cross section study carried out between 1/7/2022 and April 2023 that enrolling 300 patients from governmental hospitals from different provinces of Central and northern Iraq. The research form contained 15 fields divided into three sections. The first section contains social information such as age, gender, field of work, Residence and education. The second part consists of diagnosis and lab. Finding. The third part related to antibiotic uses: Number of AB prescribed, duration of using, type of use, route of administration, AB interaction, dose administration of AB, indication of Ab, and Class of AB. RESULTS: Results: A total of 300 eligible patients, 165 patients (55.0%) were male and 135 (45.0%) were female, patients were <20 years ages were 117 (39.0%), 25 (8.3%) from the 20-29 years age group, 40-49 years ages were 28 (9.3%) and >50 years ages were 105 (35.0%) were which belong to the pediatric population. The 198 patients (66.0%) were used cephalosporins and 106 (53.5%) of them used alone. A 13-19% percentage of patients had used penicillin, carbapenem, anti-fungal, and aminoglycoside in combination form. CONCLUSION: Conclusions: The implementation of clinical guidelines, the provision of direct instruction, and the regular dissemination of antibiogram data have the potential to encourage a more judicious consumption of antibiotics.

Impact of leadership styles adopted by head nurses on job satisfaction: a comparative study between governmental and private hospitals in Jordan.

BACKGROUND: Previous studies demonstrated that leadership styles are the basis of daily interactions between leaders and employees and facilitate and enhance work processes. AIM: This study aimed to explore how the leadership styles of nurse leaders affect job satisfaction among working nurses. METHODS: Quantitative, descriptive and comparative methods were used. Three main Ministry of Health hospitals in different areas of Jordan and three private hospitals in Amman were selected. RESULTS: Among the leadership styles measured by the Multi-factor Leadership Questionnaire 5X, transformational leadership had been used by head nurse managers in both settings more than transactional leadership and passive-avoidant leadership. The level of job satisfaction among nursing staff was higher in public hospitals than in private hospitals in this study. A positive relationship was found between the overall score for transformational leadership and job satisfaction (r = 0.374**). The overall transactional leadership score correlated positively with job satisfaction (r = 0.391**). Conversely, the overall correlation between passive-avoidant leadership and job satisfaction was negative (r = -0.240). CONCLUSION: The increased development of transformational leadership behaviours increases nurses' job satisfaction and thus contributes to an increased retention of nurses. IMPLICATIONS FOR NURSING MANAGEMENT: The ability of hospitals to address the leadership styles of head nurses and their impacts on job satisfaction will be strengthened.

The Road Ahead and Challenges of Revenue Cycle Management in Saudi Governmental Hospitals.

Healthcare providers use revenue cycle management (RCM) to track patient billing and revenue. The revenue cycle collects data from various systems and compiles it into a single RCM system connected to payers. Effective system integration improves revenue and financial stability. The aim is to assess RCM feasibility in Saudi Arabia's governmental hospitals, examine financial management, and recommend practical implementation. In this study, healthcare leaders were interviewed face-to-face and via audio recording to collect qualitative data in response to semi-structured questions. Key informants from seven main hospitals were interviewed. Respondents understood RCM and identified internal and external challenges in hospital financial management. Government hospitals face accountability obstacles. Two of the seven surveyed hospitals operate business clinics using a fee-for-service model. The billing system is not integrated with the information system. The RCM system faces challenges such as unclear vision, lack of accountability, staff resistance, process redesign, and importance of project management. Despite these challenges, respondents still value RCM and recognize its importance in improving hospital revenue management. Effective implementation of RCM requires significant transformational processes, including vision, governance, accountability, proper training, and effective monitoring and evaluation processes. Communication should also be emphasized, and the patient's perspective must be brought into focus. Involving all stakeholders can create direct and holistic patient benefits; therefore, bringing them on board is crucial. New approaches are required to enhance healthcare in Saudi Arabia, addressing gaps in revenue optimization and RCM. Future research should evaluate the move from government-funded to self-operated hospitals, providing a better understanding of the challenges and opportunities.

Intentions and barriers toward breastfeeding among Jordanian mothers-A cross sectional descriptive study using quantitative method.

PROBLEM/BACKGROUND: Breastfeeding is very important for both mother and infant. Within Jordanian hospitals, intentions and barriers to breastfeeding have not been addressed effectively during preparing policies in routine antenatal care or in maternal and child health care. AIM: To identify the intentions and barriers toward breastfeeding among Jordanian mothers with a specific focus on women from low income circumstances. METHODS: A cross-sectional descriptive study using quantitative methods was adopted in this study. Data was collected via the Modified Infant Feeding Intention Scale (MIFIS). FINDINGS: Women reported that for the most part their intention to feed their babies was using formula milk. However, they reported a desire to breastfeed but this intention could be hindered due to limited social support and challenges related to work arrangements. Further, participants also reported concerns regarding perceived pain that breastfeeding may cause and concerns regarding changes in their body shape and weight as a result of breastfeeding. CONCLUSION: Views toward breastfeeding among Jordanian women are not homogeneous. Policymakers and nurse educators should be cognizant of findings from this study and use them as guidelines for decision making. Efforts to improve intention toward breastfeeding can be achieved through structured and targeted educational programs for women from low income circumstances, and by modifying policies concerning work conditions for mothers to enable them to breastfeed their babies.

Patient safety culture and job stress among nurses in Mazandaran, Iran.

BACKGROUND: Paying attention to patient safety is a basic right and a necessary issue in providing medical care, and failure to observe it leads to irreparable damage. One of the factors affecting an individuals' performance in an organization is stress, which also endangers their health. OBJECTIVE: To determine the relationship between patient safety culture and levels of job stress among the nurses working in the hospitals affiliated with Mazandaran University of Medical Sciences. METHODS: The present study was carried out using a cross-sectional method in the hospitals affiliated with Mazandaran University of Medical Sciences in 2016. A multistage stratified sampling method using a Morgan Table was employed to select 380 nurses as the study sample from among 3,180 nurses. They were selected by a multistage stratified sampling method. The study instruments were Stinemetz Standard Job Stress Questionnaire and Hospital Survey on Patient Safety Culture (HSOPSC). After the required data were collected, they were analyzed using descriptive and inferential statistical methods (Pearson correlation, independent-samples t-test, and ANOVA) through SPSS version 23. RESULTS: The results of the present study showed that 75% of the nurses experienced average and high levels of stress. Among different dimensions of safety culture, organizational learning and handoffs and transitions obtained the highest and the lowest scores, respectively (72.5 and 24.5). The mean score of safety culture dimensions was 51.52. The results of the Pearson correlation test showed that there was a direct significant relationship between different dimensions of safety culture among nurses and the level of stress (p≤0.05). CONCLUSION: According to the findings, patient safety should be considered as a strategic priority for the senior managers of the health system. In order to enhance patient safety, managers should pay special attention to evaluating safety culture in organizations that deliver health service, especially hospitals.

Retrospective assessment of the status and determinants of tuberculosis treatment outcome among patients treated in government hospitals in North Shoa Administrative Zone, Amhara Regional State, Ethiopia.

BACKGROUND: One of the specific targets of Directly Observed Treatment, Short-course detailed in the updated Global Plan (2011-2015) was to achieve a treatment success rate of 87% by 2015. This strategy was introduced to Ethiopia in 1995 to reach full coverage in 2005; however, by 2009, treatment had not been as successful as expected. OBJECTIVE: This study was conducted to determine treatment success rate and identify risk factors for tuberculosis (TB) treatment outcomes in North Shoa Administrative Zone, Amhara Regional State, Ethiopia. METHODS: A retrospective cohort study was conducted on all TB patients (739) who registered for TB treatment from September 1, 2012 to August 31, 2014 at public hospitals in North Shoa Administrative Zone, Ethiopia. Data were gathered by using a pretested structured medical record checklist. Four data collectors and two supervisors were involved in gathering the data. The data were analyzed using descriptive statistics and logistic regression and were entered into Epi Info and analyzed by using the SPSS software package version 20. RESULTS: This study revealed that the TB treatment success rate was 86.1% (169 [22.9%] cured and 467 [63.2%] completed). In addition, 22 (3%) of the study participants defaulted their treatment of which 19 (86.4%) withdrew during the intensive phase. The multiple logistic regression model revealed that the study year of treatment, sputum smear positivity at the second-month follow-up, history of treatment default, and subsequent hospitalization were significantly associated with the TB treatment outcome. CONCLUSION: The TB treatment success rate in the study area was low compared to that estimated by World Health Organization to achieve by 2015. Therefore, Federal Ministry of Health and Regional and Zonal Health Office have to strengthen the interventions on minimizing anti-TB treatment default rate through well-organized documentation, follow-up on TB patients, and awareness-creation programs.