Mehdi Sarafi; Behzad Azimi; Mohammad Karimian; Gholamreza Ebrahimiseraj
Volume 13, Issue 3 , July 2025, , Pages 153-157
Abstract
Objective: This study aimed to investigate the incidence and risk factors for surgical site infection (SSI)following appendectomy.Methods: This retrospective cohort study examined the records of 180 patients who underwent appendectomyin Emam Khomeini Hospital from January 2021 to December 2022. The research ...
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Objective: This study aimed to investigate the incidence and risk factors for surgical site infection (SSI)following appendectomy.Methods: This retrospective cohort study examined the records of 180 patients who underwent appendectomyin Emam Khomeini Hospital from January 2021 to December 2022. The research tool included a demographicprofile form and a research checklist. After obtaining the ethical approval from the university, the researchervisited the hospital and extracted the required data from the patient’s clinical file (in accordance with theresearch checklist). Then, the collected data were entered into SPSS software (version 21) for data analysis.Results: Of the 180 patient records included in the study, 28 (15.6%) developed SSI. The descriptive analysisrevealed that among the patients with SSI, 19 patients were men (67.9%), 18 (64.3%) had a low BMI, 8 (28.6%)had blood type A-, and 19 (67.9%) patients had a fever below 38 °C. Regarding clinical symptoms, 1 (3.6%)patient had gangrenous appendicitis, and 22 (78.6%) required urgent surgery. Notably, no significant riskfactors for SSI were identified. There was no association between SSI status and demographic variables,clinical symptoms, or underlying conditions (p>0.05).Conclusion: The incidence of SSI following appendectomy was relatively higher than in previous studies,though no significant risk factors were identified. Given this, standardization and adherence to evidence-basedinfection control practices, such as an appropriate preoperative antiseptic preparation, timely administrationof prophylactic antibiotics, and the use of laparoscopic techniques when feasible, might help reduce SSI risk.
Zoya Hadinejad; Mehrdad Farrokhi; Shokoufeh Ahmadi; Mohammad Saatchi; Hamidreza Khankeh
Volume 13, Issue 2 , April 2025, , Pages 105-114
Abstract
Objectives: This qualitative study aimed to identify the key challenges associated with managing patients affected by biological emergencies in Iran.
Methods: This study was part of grounded theory research using the constant comparative analysis method proposed by Corbin (2014). Data were gathered ...
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Objectives: This qualitative study aimed to identify the key challenges associated with managing patients affected by biological emergencies in Iran.
Methods: This study was part of grounded theory research using the constant comparative analysis method proposed by Corbin (2014). Data were gathered through semi-structured interviews with 25 individuals with expertise or experience in managing biological emergencies. Purposive sampling, followed by theoretical sampling, was employed until theoretical saturation was reached. Data collection was conducted between April and November 2023, and MAXQDA software (2020) was used for data analysis.
Results: After several rounds of data analysis and summarization, considering similarities and differences, four main categories and 14 subcategories were identified. The main categories included: 1) lack of a comprehensive risk communication strategy, 2) inefficiencies in patient flow mismanagement, 3) systemic political and governance challenges, and 4) deficiencies in resource allocation and utilization.
Conclusion: This study highlighted the challenges faced by Iran’s Healthcare system in managing affected individuals in biological emergencies. Key issues included mismanagement of patient flow and systemic inefficiencies. Addressing these challenges is essential for enhancing the effectiveness and sustainability of Iran’s Healthcare system. Further research is recommended to provide practical strategies for managing biological emergencies in the future.
Hosein Zakeri; Elham Pishbin; Behrang Rezvani Kakhki; Hanie Ghashghaee; Sayyed majid Sadrzadeh; Masumeh Sadeghi; Elnaz Vafadar Moradi
Volume 12, Issue 3 , July 2024, , Pages 124-129
Abstract
Objective: Geriatric trauma refers to injuries sustained by elderly individuals, typically those aged 65 years andolder. The management of geriatric trauma in the Emergency Department requires a comprehensive approachthat takes into account the physiological changes associated with aging, as well as ...
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Objective: Geriatric trauma refers to injuries sustained by elderly individuals, typically those aged 65 years andolder. The management of geriatric trauma in the Emergency Department requires a comprehensive approachthat takes into account the physiological changes associated with aging, as well as the increased vulnerabilityand complexity of injuries in this population.Methods: This is a cross-sectional study aimed at evaluating the etiology of trauma in geriatric patients referredto the ED of level-1 an academic center. All patients with complaints of trauma are evaluated and patients over65 years enrolled in the study. Data were analyzed by SPSS 26.Results: 319 patients were investigated, 49.8% male and 50.2% female. The most common underlying diseasesare high blood pressure, diabetes type 2, and ischemic heart disease. The most common trauma cause wasfalling from the same level (48.9%), followed by a fall from a height (16.6%), accidents with cars (16%), andmotorcycles (9.1%). The most common injury was extremities trauma (71.5%) following head trauma (13.2%)and chest trauma (6%). The severity of injury in extremities was higher in women, and chest trauma was moresevere in men.Conclusion: The fall and subsequent car accident had the highest frequency as a cause of trauma in elderlypatients admitted to our academic trauma center. Hypertension and diabetes have also been the most commonunderlying diseases. Head and neck injuries are life-threatening and critical in a larger number of patients thanother injuries, and protecting them can be effective in reducing mortality and serious injuries in elderly traumapatients.
Hedayat Jafari; Mahbobeh Yaghobian; Morteza Darabi Nia; Abolfazl Hosseinnataj; Pooyan Ghorbani Vajargah; Samad Karkhah; Maryam Anneh-Mohammadzadeh
Volume 12, Issue 2 , April 2024, , Pages 88-94
Abstract
Objective: The present study aimed to determine the prevalence and severity of moral distress (MD) and itsassociated factors among emergency department nurses.Methods: This cross-sectional study was conducted in 2023 on 172 nurses from the emergency departments ofmedical training centers affiliated with ...
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Objective: The present study aimed to determine the prevalence and severity of moral distress (MD) and itsassociated factors among emergency department nurses.Methods: This cross-sectional study was conducted in 2023 on 172 nurses from the emergency departments ofmedical training centers affiliated with Mazandaran University of Medical Sciences. The census method wasused to collect the data, which included demographic variables and Corley’s MD questionnaire. The Data wereanalyzed using SPSS software (version 22), using an independent T-test, analysis of variance (ANOVA), andmultiple regressions.Results: Out of 172 nurses, 60.5% were women, with an average age of 32.52±6.88 years. The resultsdemonstrated an average MD score of 69.73±25.68. In terms of frequency and intensity, around 53.5% ofthe participants experienced MD at a low level (0-72), while the remaining 46.5% reported experiencing itat a medium level (14-73). A significant association was found between MD and age (p=0.037), workplacehospital (p=0.005), and history of mental disorders (p=0.005). Furthermore, linear regression analysis revealeda statistically significant association between MD, marital status, and occupational type (p<0.05).Conclusion: The results showed that nurses had low to moderate levels of MD. Several factors, includingage, history of mental disorders, marital status, employment type, workplace hospital, and education, wereassociated with the overall MD score. To reduce MD and its negative effects on nurses, it is necessary toaddress these factors and develop an effective strategy for identifying and managing MD to improve nursingcare quality
Behrouz Samei; Javad Babaie; Jafar Sadegh Tabrizi; Homayoun Sadeghi-bazargani; Saber Azami-Aghdash; Naser Derakhshani; Ramin Rezapour
Volume 11, Issue 3 , July 2023, , Pages 109-118
Abstract
Objective: This study aimed to comprehensively determine the factors that affect the hospitals’ functionalpreparedness in response to disasters.Methods: A systematic review of studies published in English and Persian up to the end of 2022 was performedby searching PubMed Central, Web of Science, ...
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Objective: This study aimed to comprehensively determine the factors that affect the hospitals’ functionalpreparedness in response to disasters.Methods: A systematic review of studies published in English and Persian up to the end of 2022 was performedby searching PubMed Central, Web of Science, Scopus, ProQuest, SID, and Elmnet databases. Articles thatassessed hospitals’ functional preparedness were searched by using a combination of medical subject headingterms and keywords including disaster, emergency, preparedness, hospital preparedness, health care facilitiespreparedness, hospital functional preparedness, health care facilities functional preparedness, readiness, andeffective factors. Additionally, journals and gray literature were manually searched. Two independent reviewersscreened the eligible papers. The inclusion criteria were the full text should be published up to the end of 2022,in both Persian and English, and focus on hospital preparedness. The extracted data were manually analyzed,summarized, and reported using the content analysis method.Results: Of the 3465 articles, 105 studies were eventually included in the final analysis. Eighty-two influentialfactors were identified and classified into seven categories: government, coordination, control, and commanding(7 factors), existing guidelines and preparedness plans (12 factors), regulations (6 factors), supplying of resources(37 factors), education and training (8 factors), multi-layered information management and communicationsystems (8 factors), and contextual factors (4 factors).Conclusion: There are different dimensions of hospital preparedness for disasters, each of which is influencedby several independent factors. Addressing these factors will enhance the actual functional preparedness ofhospitals encountering disasters.
Farhad Heydari; Alireza Gholamian; Majid Zamani; Saeed Majidinejad
Volume 6, Issue 4 , October 2018, , Pages 292-299
Abstract
Objective: To evaluate the efficacy and safety of intramuscular ketamine and haloperidol in sedation of severely agitated patients in emergency department (ED).Methods: This randomized, double-blind clinical trial study was performed on agitated patients referring to two university educational hospitals. ...
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Objective: To evaluate the efficacy and safety of intramuscular ketamine and haloperidol in sedation of severely agitated patients in emergency department (ED).Methods: This randomized, double-blind clinical trial study was performed on agitated patients referring to two university educational hospitals. Patients were randomly assigned to receive intramuscular (IM) haloperidol (5 mg) or IM ketamine (4 mg/kg). The primary outcome was time to adequate sedation (AMSS ≤ +1). Secondary outcomes included the need for additional sedatives, required intubation, duration of hospitalization, and side effects. Results: The 90 agitated patients were enrolled. The mean age was 30.37±7.36 years (range 18–56); 74% (67/90) were men. The mean time to adequate sedation in ketamine group (7.73 ± 4.71 minutes) was significantly lower than haloperidol group (11.42 ± 7.20 minutes) (p= 0.005). 15 minutes after intervention, the sedation score did not differ significantly in both groups (Ketamine:0.14 ± 0.59 vs. Haloperidol: 0.30 ± 0.60; p=0.167). The incidence of complications was not significantly different between groups. The physician's satisfaction from the patients’ aggression control was significantly higher in ketamine group.Conclusion: These data suggest ketamine may be used for short-term control of agitated patients, additional studies are needed to confirm if ketamine is safe in this patient population. Given rapid effective sedation and the higher physician satisfaction of ketamine in comparison to haloperidol, it may be considered as a safe and appropriate alternative to haloperidol.IRCT Code: IRCT20180129038549N5
Mahsa Dehghani; Nazila Moftian; Peyman Rezaei-hachesu; Taha Samad-soltani
Volume 5, Issue 2 , April 2017, , Pages 79-89
Abstract
Objective: To systematically review the current literature of simulation in healthcare including the structured steps in the emergency healthcare sector by proposing a framework for simulation in the emergency department.Methods: For the purpose of collecting the data, PubMed and ACM databases were used ...
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Objective: To systematically review the current literature of simulation in healthcare including the structured steps in the emergency healthcare sector by proposing a framework for simulation in the emergency department.Methods: For the purpose of collecting the data, PubMed and ACM databases were used between the years 2003 and 2013. The inclusion criteria were to select English-written articles available in full text with the closest objectives from among a total of 54 articles retrieved from the databases. Subsequently, 11 articles were selected for further analysis.Results: The studies focused on the reduction of waiting time and patient stay, optimization of resources allocation, creation of crisis and maximum demand scenarios, identification of overcrowding bottlenecks, investigation of the impact of other systems on the existing system, and improvement of the system operations and functions. Subsequently, 15 simulation steps were derived from the relevant studies after an expert’s evaluation.Conclusion: The 10-steps approach proposed on the basis of the selected studies provides simulation and planning specialists with a structured method for both analyzing problems and choosing best-case scenarios. Moreover, following this framework systematically enables the development of design processes as well as software implementation of simulation problems.
Amir Khorram-Manesh; Johan Berlin; Eric Carlström
Volume 4, Issue 4 , October 2016, , Pages 186-196
Abstract
The aim of the current review wasto study the existing knowledge about decision-making and to identify and describe validated training tools.A comprehensive literature review was conducted by using the following keywords: decision-making, emergencies, disasters, crisis management, training, exercises, ...
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The aim of the current review wasto study the existing knowledge about decision-making and to identify and describe validated training tools.A comprehensive literature review was conducted by using the following keywords: decision-making, emergencies, disasters, crisis management, training, exercises, simulation, validated, real-time, command and control, communication, collaboration, and multi-disciplinary in combination or as an isolated word. Two validated training systems developed in Sweden, 3 level collaboration (3LC) and MacSim, were identified and studied in light of the literature review in order to identify how decision-making can be trained. The training models fulfilled six of the eight identified characteristics of training for decision-making.Based on the results, these training models contained methods suitable to train for decision-making.
