Background: Medication errors may happen in any hospital setting. Medication error reporting can enhance patient safety and provide valuable information about reasons behind errors. Objectives: The present study aimed to determine nurses' perspectives on the reasons behind medication errors and the barriers to error reporting. Methods: This cross-sectional study was conducted in 2015 on 213 hospital nurses working in three hospitals in Kerman, Iran. Nurses working in different inpatient wards were selected through random sampling. Data were collected using a three-part questionnaire on nurses' demographic characteristics, reasons behind medication errors, and reasons for not reporting them. Data analysis was done through the independent sample t-test and the one-way analysis of variance. Results: The most and the least important reasons behind medication errors were nurses' insufficient attention to patients' medical records (3.63 ± 1.29) and the high number of tasks (2.01 ± 0.99), respectively. Moreover, the most and the least important reasons for not reporting medication errors included forgetting to report (2.80 ± 1.20) and fear over being blamed by doctors (2.03 ± 0.98), respectively. Conclusion: Nurse- and management-related factors were the most important reasons behind medication errors and not reporting them, respectively. Designing an efficient system for medication error reporting and a systematic approach for evaluating and managing error risk factors is recommended.

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Background: The ethical climate of hospitals and job satisfaction are two main factors behind nurses' productivity. Yet, there is limited information about ethical climate and nurses' job satisfaction in the operating room (OR). Objective: This study aimed to investigate the relationship of ethical climate with nurses' job satisfaction in the OR. Methods: This cross-sectional study was done on 197 OR nurses. The Olson Hospital Ethical Climate Survey and the Minnesota Job Satisfaction Questionnaire were used for data collection. Data were analyzed by doing Spearman's rank correlation. Results: About half of the participants had a moderate job satisfaction and negative perceptions about the ethical climate of the OR. Ethical climate was significantly correlated with nurses' job satisfaction (r = 0.93, P < 0.001). Conclusion: There are some defects in the ethical climate of the ORs. Health policymakers need to devise strategies to improve both ethical climate and nurses' job satisfaction in the ORs.

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Background: Hospital beds are among valuable resources for care delivery. Therefore, optimum use of them is crucial for increasing the efficiency of health-care services and controlling health-care costs. Objective: This study intended to evaluate inappropriate patient stay (IPS) in hospital settings and its reasons based on the appropriateness evaluation protocol. Methods: This cross-sectional study was conducted on 335 patients hospitalized in a tertiary care university hospital. Data were gathered prospectively by 13 hospital nurses during a 6-month period. IPS rate was evaluated using a checklist, the 27 criteria of which were related to medical services, nursing/life support services, and patient's conditions. Moreover, a 12-item checklist was used to determine physician-, hospital-, and patient/family-related factors behind inappropriate hospital stay. Results: In total, 121 of 1925 (6.3%) hospitalization days of 335 patients were determined to be inappropriate. Neurosurgery and gynecology wards had the highest and the lowest inappropriate hospital stay rates (22.5% vs. 0%), respectively. The main reasons behind inappropriate hospital stay were hospital-related factors (33.1%), physician-related factors (29.1%), and patient-related factors (21.3%). Conclusion: A wide variety of physician-, hospital-, and patient/family-related factors contribute to IPS. Given the multifactorial causes of IPS, reducing its rate necessitates multidisciplinary approaches.

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Background: A number of studies on Iranian nurses' job stress or job satisfaction are available. However, studies on the relationship between these two variables among Iranian nurses are rare. Objectives: This study aimed to investigate job stress and job satisfaction among nurses working in Kashan Shahid-Beheshti Hospital, and the relationship between these two variables. Methods: A cross-sectional study was conducted on 260 nurses with 1 year experience in nursing who worked in Shahid Beheshti Hospital in Kashan, Iran, during 2015. A three-part questionnaire was used including questions on demographic variable, the organization's performance satisfaction scale, and the 35 items hospital stress scale. Descriptive and inferential statistics were used to analyze the data. Results: Among the respondents, 65.7% were female, 82.7% were staff nurse, 68.9% had a bachelor degree, and 72.8% of the respondents worked in rotating shifts. The mean overall job stress and job satisfaction scores were 109.06 ± 16.22 and 129.03 ± 17.63, respectively. A significant correlation was found between job stress and job satisfaction scores (r = 0.30, P < 0.001). Married and unmarried nurses were not significantly different in job satisfaction or in job stress scores. However, the mean job stress score was significantly higher in female nurses than in males (P = 0.042). The mean job satisfaction scores and the mean job stress scores were significantly different in nurses with various degrees (P < 0.001 and P = 0.002). The mean job satisfaction scores were significantly different in nurses with different job positions (P = 0.042). Conclusion: Nurses showed a moderate job stress score and a moderate job satisfaction. A significant correlation was found between nurses' job stress and job satisfaction. Steps should be taken by the authorities to improve the nurses' working conditions and to decrease their job stress.

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Background: A child at the age of 6 months requires an additional and improved nutrition, besides mother's milk for better growth and immunity, to protect them from many diseases. Lack of timely initiation of complementary feeding (CF) is an important cause of undernutrition in children under 5 years of age which is an underlying cause of more than 40% of morbidity and mortality. Objectives: The study aimed to estimate the prevalence of and factors related to timely introduction of CF in children 6–24 months of age. Methods: This was a mixed-method study. This study was conducted in a rural area of Hyderabad, Pakistan. A sample of 106 households was selected through multistage sampling technique. Mothers of children between 6 and 24 months of age were interviewed through questionnaire and in-depth interview guide for quantitative and qualitative parts, respectively. Results: The prevalence of early initiation of CF in the study area was found out to be 48%, those who started in time believed that children were old enough (42%) or the child was crying excessively (33%), and hence, they had to introduce complementary foods for children. In total, around 63% of mothers were empowered to decide about their children feeding. Factors such as mothers' education, living in cemented house, and watching television were significantly associated with their children given CF at the age of 6 months. Qualitative data suggested that mothers commonly weaned their infants with animal milk, tea, and biscuits, and they lacked in correct knowledge about CF practices. Conclusion: A significant proportion of mothers in rural areas of Pakistan delay CF. We found that maternal education, residence in cemented houses, and exposure to media play a part in timely introduction of CF to children aged 6–24 months.

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Background: Controversies exist regarding the effects of continuous positive airway pressure (CPAP) mask on hemodynamic parameters after open heart surgeries. Objectives: This study aimed to investigate the effects of CPAP mask on hemodynamic parameters after open heart surgery. Methods: This randomized controlled trial was conducted in 2015 on 72 patients who were to undergoing open heart surgery in Kashan, Iran. Patients were randomly assigned to an intervention (n = 36) and a control (n = 36) group. After postoperative extubation, a CPAP mask (with a pressure of 5 cmH₂O) used for patients in the intervention group (30 min every 8 h for five times). A checklist was used to document hemodynamic parameters 10 min before and after each phase of the intervention. Data analysis was performed using the repeated measures analysis of variance and the Chi-square, Fisher's exact, and the independent-sample t-tests. Results: Results showed that CPAP mask had no significant effects on systolic blood pressure (P = 0.12), heart rate (P = 0.34), and mean arterial pressure (P = 0.12). However, it significantly affected diastolic blood pressure (P < 0.001) and central venous pressure (P < 0.01). Conclusion: CPAP mask has no negative effects on hemodynamic parameters. Thus, it can be safely used for patients who undergo open heart surgeries.

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Background: For children and their families, the diagnosis of a chronic disease can come as a mental and psychological shock. Objective: The present study was undertaken to compare the effect of nurse-led and peer-led training methods on the stress of mothers of children with chronic illness. Methods: A two-group, pre-test and post-test design, clinical trial was conducted on sixty mothers of children with chronic diseases. Using a permuted-blocked randomized sampling method, the subjects were equally assigned into two groups of 30 to receive either peer-led or nurse-led training. All of the mothers in the two intervention groups were responded the parenting stress index within 48–72 h after the diagnosis and hospitalization of their child and then again after the end of the training program. The mothers in each intervention group were divided into small subgroups of 2–3 and each subgroup participated in three 30 min training sessions held either by a trained peer or by a nurse. Data analysis was performed using t-test, Chi-square test, Mann-Whitney, and paired t-test. Results: No statistically significant difference was observed between the stress scores of peer-led group (320.29 ± 44.38) and nurse-led group (319.60 ± 41.12) before the intervention. After the implementation of the intervention programs, a greater decrease was observed in the mean stress score of the nurse group (314.48 ± 19.67), as compared to the peer group (320.5 ± 22.92). However, the difference was not statistically significant (P > 0.05). Conclusion: Peer- and nurse-led training methods did not yield much different results. Therefore, it is recommended to substitute peer-led training method for nurse-led training method, due to the nurses' huge workload.

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