Period Prevalence and Reporting Rate of Needlestick Injuries to Nurses in Iran: A Systematic Review and Meta-Analysis

Study on needle stick injuries during surgery and blunt needle use for reducing occupational exposure and hygiene benefits

BACKGROUND

The conventional round suture needle poses a significant risk of needle stick injuries among surgical physicians, identified as a global occupational hazard by the World Health Organization, increasing hospital costs and exposure to bloodborne pathogens. While novel blunt suture needles have shown promise in reducing these risks, their adoption is limited domestically, prompting a study to compare their efficacy against traditional sharp needles in reducing needle stick injuries among surgical physicians.

OBJECTIVE

To investigate suture needle stick injuries among surgical doctors during operations and assess the application effectiveness of a novel blunt suture needle.

METHODS

A total of 106 surgical department physicians from March 2021 to February 2023 participated in the study. After completing a questionnaire survey on suture needle injuries during surgery, the participants were divided into two groups. Over a 6-month intervention period, the control group used regular round needles while the study group utilized novel blunt suture needles. Subsequently, suture needle injury incidence rates and economic hygiene benefits were compared between the two groups.

RESULTS

The suture needle injury questionnaire survey showed that over the past 6 months, among 106 surgical department physicians, 20 needle stick injuries occurred, yielding an incidence rate of 18.87%. The highest incidence (65.00%) was during suturing incisions longer than 10 cm, primarily when visibility was poor (70.00%). Surgeons linked most injuries (60.00%) to prolonged surgical duration causing fatigue. Although 85.00% detected injuries within 1 minute, only 40.00% were reported, often due to perceived reporting complexity. Following intervention, the study group had significantly fewer injuries per surgery and lower occupational exposure costs compared to the control group (p< 0.05).

CONCLUSION

Surgical department physicians commonly sustain suture needle injuries while suturing incisions of 5-10 cm length under poor visibility, exacerbated by prolonged surgical duration. Despite detecting most injuries within 1 minute, only 40% are reported. The implementation of novel blunt suture needles significantly decreases injury rates, resulting in reduced occupational exposure costs and favorable safety and economic hygiene outcomes.

Prevalence of needle-stick injury in Iranian nurses: an updated systematic review and meta-analysis of observational studies

BACKGROUND

The aim of this study was to conduct a systematic review and meta-analysis to estimate the prevalence of needle-stick injury among Iranian nurses.

METHODS

We conducted a systematic review and meta-analysis to estimate the prevalence of needle-stick injury among Iranian nurses. A comprehensive search of Web of Science, PubMed, Scopus, Scientific Information Database, and MagIran was performed, yielding 29 observational articles comprising 8842 nurses. The studies ranged from 2006 to 2023, with sample sizes varying from 68 to 1555 individuals. Methodological quality was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology checklist. The pooled prevalence was calculated using the random-effects model, and subgroup analyses were conducted based on hospital type and gender. The data was analyzed using Stata software version 16.

RESULTS

The pooled prevalence of needle-stick injury among Iranian nurses was found to be 46% (95% Confidence Interval [CI]: 39-53%). Subgroup analysis revealed significant difference in prevalence between teaching hospitals (47%; 95% CI: 39-54%) and military hospitals (38%; 95% CI: 31.1-44%). The prevalence of NSI in region 1 (Tehran and surrounding provinces) and other regions was 45.1% (95% CI: 37-54%) and 49.17% (95% CI: 36.5-61.7%). Gender-based analysis showed higher prevalence in women (58%; 95% CI: 44-71%) compared to men (55%; 95% CI: 43-66%).

CONCLUSION

Needle stick injuries has a high prevalence among Iranian nurses, especially nurses working in teaching hospitals. Therefore, it seems necessary to use interventions to reduce it.

Prevalence and associated factors of needle stick and sharp injuries among nurses: A cross-sectional study

Objectives

Workplace safety is essential to occupational health practices among healthcare providers, especially for nurses vulnerable to work-related hazards such as needle stick and sharp injuries. In Yemen, the underestimation and absence of reporting system and lack of health supplies in a collapsed health system exacerbated the needle stick and sharp injuries. This study aimed to identify the prevalence and associated factors of needle stick and sharp injuries among nurses in Taiz, Yemen.

Methods

A cross-sectional study was conducted on a sample of 151 nurses working in three public hospitals in Taiz City. A semi-structured questionnaire was designed and delivered to the participants.

Results

The prevalence of needle stick and sharp injuries among nurses was very high (95.36%), and around half were injured more than five times. Female nurses and those in an emergency department were more likely to be subjected to needle stick and sharp injuries (p = 0.018 and 0.021, respectively). Needle stick was the most common cause of injury (62.77%), and the fingers were the most exposed injury site (79.17%). Non-reporting injuries were very high (73.61%), and only one-third (34.21%) of them proceeded in the process of management, and less than one-quarter (23.68%) had been vaccinated.

Conclusion

The prevalence of needle stick and sharp injuries among nurses in Taiz was very high, and determined by gender and place of work. Post-injury reporting and precautions were poor, which may increase the prevalence of hospital-acquired infections among clients and healthcare providers.

Predictors of hospital nursing staff's adherence to safe injection guidelines: application of the protection motivation theory in Fars province, Iran

BACKGROUND

Needle stick injuries (NSI) can lead to dangerous infectious diseases for health care workers. This study aimed to determine the predictors of observance of safe injection guidelines in hospital nursing staff, based on protection motivation theory.

METHODS

This cross-sectional study was conducted on the nursing staff of five randomly selected teaching and general hospitals of Shiraz University of Medical Sciences, Fars province, Iran, in 2021. Data were collected using a researcher-made questionnaire which was developed based on protection motivation theory. Data were processed and analyzed using SPSS 22 and Amos 24 at a significance level of  < 0.05. Pearson's correlation coefficient, Multiple linear regression, and Structural Equation Modeling were used.

RESULTS

The mean age of the participants (No = 280) was 32.5 ± 8.09 years. Most of the participants [80%] had encountered NSI, patients' blood, or body fluids at least once. Protection motivation was the only predictor of protective behaviors (β = 0.573), while perceived efficacy (β = 0.142) and perceived rewards (β = -0.229) were the strongest predictors of motivation. The structural equation modeling analysis showed that standardized total effects of protection motivation, perceived response costs, rewards, and efficacy on the protective behaviors were 0.573, -0.159, -.104, and 0.81, respectively. While standardized total effects of perceived rewards, efficacy, and response cost on protection motivation were -0.229, 0.142, and -0.033, respectively. The model fit indices indicated the acceptable final model fit.

CONCLUSION

The results suggest that perceived efficacy, perceived effectiveness, and perceived rewards were the most important predictors of adherence to Safe Injection Guidelines in nursing staff.

Prevalence of needle stick and its related factors in Iranian health worker: an updated systematic review and meta-analysis

Background

Healthcare workers (HCWs) are at risk of acquiring blood-borne infections such as hepatitis B, hepatitis C, and human immunodeficiency virus through needlestick injuries (NSIs). We aimed to investigate the prevalence of needlestick injuries and other related indicators among HCWs in Iran through a systematic review and meta-analysis.

Methods

We searched various databases until the end of May 2023 for studies reporting the prevalence of NSIs among healthcare workers in Iran. We used a random model with 95% confidence intervals (CIs) to analyse the data and the Joanna Briggs Institute (JBI) tool to evaluate the quality of included studies. We conducted and reported the study according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.

Results

We included 87 studies in the analysis and found that 47% (95% CI = 42-52, I2 = 98.9%) of Iranian HCWs experienced NSI. NSIs were most frequently related to syringe needles (58%; 95% CI = 52-65, I2 = 96.8%) and most often caused by recapping (30%; 95% CI = 22-38, I2 = 98.5%). In this study, 56% (95% CI = 45-67, I2 = 98.6%) of HCWs with NSIs did not report their injury. Moreover, the prevalence of NSIs the highest in the morning shift (0.44; 95% CI = 0.36-0.53, I2 = 97.2%), emergency unit (0.20; 95% CI = 0.16-0.24, I2 = 93.7%), and intensive care unit (0.20; 95% CI = 0.16-0.24, I2 = 94.3%).

Conclusions

To reduce the high prevalence of NSIs, HCWs, especially those in emergency departments, should use safety equipment. Healthcare managers should provide a calm and stress-free environment for HCWs, educate them on safety principles and standards, and support experienced HCWs with NSIs.

Exposure to needle stick injuries among health care workers in hemodialysis units in the southwest of Iran: a cross-sectional study

BACKGROUND

Needle stick injury (NSI) is the most common cause of infection with blood-borne pathogens (BBP) among healthcare workers (HCWs). This study aimed to assess the prevalence of NSI and it's contributing factors among HCWs of hemodialysis (HD) units in southwest Iran.

METHODS

A cross-sectional study was performed in 13 HD centers in Shiraz, Iran. A total of 122 employees were enrolled in our study. We used self-administrated questionnaires to collect data about demographics, experiences regarding NSIs, and general health status. The statistical tests used in this study were Chi-square and Independent T-test. A P-value < 0.05 is considered significant.

RESULTS

The mean age of the study population was 36.1 ± 7.8 years (72.1%: women). Exposure to NSIs was reported by 23.0% of them at least once during the previous six months. NSI prevalence was significantly higher among those with higher age (p = 0.033), work experience > 10 years (p = 0.040), and those who graduated earlier (p = 0.031). The intravenous injection was the most common procedure leading to NSI, and being in a hurry was the most common cause. The average general health was 3.7 ± 3.2, higher among those not exposed to NSI (p = 0.042).

CONCLUSION

NSI is a prevalent hazard in HCWs of HD units. The high rate of NSI and unreported cases, besides the lack of adequate information, indicates the necessity of implementing protocols and strategies for improving the safety of this personnel. It is difficult to compare the result of this study with those performed among HCWs in other settings; hence, further studies are needed to determine whether HCWs of these units are more exposed to NSIs.

The impact of emotional intelligence and personality traits on the occurrence of unsafe behaviors and needle stick injuries among the nurses

This study was aimed to investigate the effect of emotional intelligence and some personality traits on safe behavior and needle stick injuries among the nurses. This cross-sectional study was performed on 200 nursing staff of a hospital in Iran. To collect data, individuals were asked to complete several questionnaires, including demographic questionnaire, domain-specific risk-taking questionnaire, Rosenberg self-confidence questionnaire, Buss-Perry aggression questionnaire, Goleman emotional intelligence questionnaire, and safe behavior questionnaire. Also, the number of needlestick injuries in the participants was extracted from their medical records. Data were analyzed using the SPSS software (version 22), and path analysis was performed using AMOS software. The prevalence of needle stick injuries in the subjects was estimated by 45.5 percent. The results showed that increasing risk-taking, increasing aggression, decreasing self-confidence, and decreasing emotional intelligence reduced safe behavior and increased the number of needle injuries (P < 0.001). In the present study, some personal traits affecting the occurrence of needlestick injuries were identified. It is recommended that people without these negative traits are applied in dangerous occupations with a high probability of needle stick injuries.

Prevalence, emotional and follow-up burden of insulin injection-related needle-stick injuries among clinical nurses in Shaanxi Province, west of China: A cross-sectional study

Aims and objectives

The aim of this study was to investigate the prevalence, emotional and follow‐up burden of insulin injection‐related needle‐stick injuries among clinical nurses.

Background

needle‐stick injures introduce statistically significant occupational hazards to healthcare workers. Although the large proportion of the needles injuries attributed to insulin injection, research evidence about the prevalence, emotional and follow‐up burden of such injures is lacking.

Design

Cross‐sectional study.

Methods

5389 nurses were recruited from 45 hospitals in Shaanxi, China, from November 2018 to July 2019. Participants were administrated with a questionnaire specifically developed for this study. Descriptive statistics were used to present the findings.

Results

All 5,389 nurses responded to the survey, of which 396 (7.4%) participants experienced 620 insulin injection‐related needle‐stick injuries in the past year, representing an annual prevalence of 115.0 per 1000 nurses. The annual prevalence of infection caused by the injuries was 18.7 per 1000 nurses. The injuries occurred most frequently when nurses were recapping the needle (42.4%). In the majority (98.4%) of the injuries, the hurt nurses took proper immediate actions. However, only 30.3% of nurses reported the injuries to the administrative staff, and in 43.2% of the injuries, the nurses refused or discontinued the suggested follow‐up. A large proportion (58.6%) of the hurt nurses experienced emotional changes. Multivariate logistic regression showed that department, removing and/or setting back needle caps with bare hands, frequency of insulin pen and syringes are associated with the incidence of insulin injection‐related needle‐stick injuries. This paper is reported following the STROBE recommendations.

Conclusions

This survey demonstrated a considerably high prevalence of insulin injection‐related needle‐stick injuries among clinical nurses. Even though the majority of the hurt nurses took proper immediate actions, a large quantity of them failed to report the accidents to the administrative staff and complete the suggested follow‐up. Nurses who suffered from insulin injection‐related needle‐stick injuries were subject to various negative emotional changes. It portends a statistically significant risk to occupational health management for nurses.

Relevance to clinical practice

Scientific preventive and management strategies are desirable in order to minimize the consequences of insulin injection‐related needle‐stick injuries.

The Awareness and Empowerment Aspects of the Needlesticks and Other Sharps Injuries and Reporting in Nursing Education: A Cross-Sectional Survey

BACKGROUND

Occurrence and underreporting of needlesticks and other sharps injuries (NSIs) are still immediate concerns among nursing students. This study examined the relationship between occupational health and safety (OHS) awareness and empowerment levels of nursing students and the occurrence and reporting of NSIs.

METHODS

This cross-sectional study was conducted among purposively selected 840 students in a nursing school in 2018-2019. A self-report questionnaire was used to collect data about students' sociodemographic characteristics, OHS awareness and empowerment levels, and NSIs characteristics. After bivariate analyses, multivariate logistic regression was used.

RESULTS

The number of evaluated questionnaires was 469, for a response rate of 55.8%. Participants, 21.2% (n = 99), had suffered NSIs, and 47.8% had reported their injuries. The NSIs were statistically related to age, academic year, working night shift, OHS awareness level of students, and the number of clinical placements completed by students. The odds of experiencing NSIs was 2.3 (95% confidence interval [CI] = [1.0, 5.3]) times higher in male students, 4.3 (95% CI = [2.4, 7.4]) times higher in those beyond the second academic year, and 2.5 (95% CI = [1.4, 4.4]) times higher in those who had received OHS training for a shorter period than the average duration.

CONCLUSION/APPLICATION TO PRACTICE

The levels of awareness and empowerment were higher in students who received OHS and NSIs prevention training and those who received OHS training for the above-average duration. Increasing awareness and empowerment levels of nursing students through training can reduce the occurrence and the underreporting of NSIs.

Systematic review and metal analysis on three important fungal group (dermatophytes, yeasts and saprophytes) isolated from Iranian swimming pools

The swimming pool particularly has been considered in tropical area and warm seasons in order to recreational actives and also different exercises. Therefore, poor management and unhealthy behavior of swimmers could be a cause of fungal diseases transmission among swimmers. The present study has addressed the literatures on the topic of fungal contamination of indoor/outdoor swimming pools in Iran. Based on the literature review, most common fungal contaminations were on the list of sporophytes fungus. The majority of the reported and isolated fungal were Aspergillus spp.(50 %), Rhizopus spp., Cladosporium spp.kand Penicillium spp. In addition, E. flucosom and T. mentagrophytes were the most abundant dermatophytes. Meta-analyzing of the results showed that dermatophytes, yeasts and saprophytes can be found in the swimming pool samples with a percent of 2.78 %, 14.29 and 73.73 %, respectively. High heterogeneity rate between studies was found for all types of fungal categories by I², and a p-value < 0.0001. The results of outdoor pools (hot spring pools) showed Aspergillus spp. as a predominating species and other types such as A. fumigatusm, A.feltus and A.niger with penicillium spp. as the most abundant funguses in the next order pool type. It can be concluded that the swimming pools (both indoor and outdoor) are considerable reservoir of human diseases caused by fungi, especially a potential source of dermatophyte infection.

Sharps injuries and splash exposures among healthcare workers in Arab countries: protocol of a systematic review and meta-analysis

INTRODUCTION

Sharps injuries, including needlestick injuries and splash exposures, constitute serious occupational health problems for healthcare workers, carrying the risk of bloodborne infections. However, data on such occupational incidents and their risk factors in healthcare settings are scarce and not systematically summarised in the Arab countries.The aim of this study is to conduct a systematic review and meta-analysis to review published literature about sharps injuries and splash exposures of healthcare workers in Arab countries, with the objectives to determine the incidence and/or prevalence of these events, their identified risk factors and the applied preventive and postexposure prophylactic measures.

METHODS AND ANALYSIS

The protocol is developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol guidelines. A comprehensive presearch developed in January to March 2021 in the database PubMed will be followed by a systematic search of six, core medical and health science databases: PubMed, EMBASE, Scopus, CINAHL, Web of Science and Africa-Wide Information in May 2021. The search will be performed without any filters or restrictions for publication years. Covidence systematic review tool will be used for document management, blinded screening and study selection. Two reviewers will independently screen the records, extract data and conduct risk of bias assessment. Results will be synthesised narratively in summary tables, and, if findings allow, meta-analysis will be conducted on the incidence and/or prevalence of sharps injuries and splash exposures, and on the effect size of risk factors.

ETHICS AND DISSEMINATION

The systematic review methodology does not require ethics approval due to the nature of the study design based only on published studies. The results of the systematic review will be published in a peer-reviewed journal, disseminated to stakeholders and made publicly available.

PROSPERO REGISTRATION NUMBER

CRD42021242416.

Epidemiology and risk factors of needlestick injuries among healthcare workers in Iran: a systematic reviews and meta-analysis

BACKGROUND

Occupational contact with blood and body fluids poses a significant risk to healthcare workers. The aim of this systematic review is to investigate the epidemiology and risk factors affecting needlestick injuries (NSI) in healthcare personnel in Iran.

METHODS

In March 2020, researchers studied six international databases such as Medline/PubMed, ProQuest, ISI/WOS, Scopus, Embase, and Google Scholar for English papers and two Iranian databases (MagIran and SID) for Persian papers. Joanna Briggs Institute (JBI) Critical Appraisal Checklist was used to assess quality of studies. The method of reporting was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement.

RESULTS

A total of 43 articles were included in the analysis. Results showed that females (OR = 1.30, 95 % CI 1.06-1.58, P value = 0.009), younger age (OR = 2.75, 95 % CI 2.27-3.33, P value < 0.001, rotated shift workers (OR = 2.16, 95 % CI 1.47-3.15, P value < 0.001), not attending training courses (OR = 1.30, 95 % CI 1.07-1.56, P value = 0.006), working in the surgery ward (OR = 1.83, 95 % CI 1.33-2.50, P value < 0.001), less work experience (OR = 1.43, 95 % CI 1.04-1.95, P value = 0.025) apposed a greater risk factors for NSI among healthcare workers.

CONCLUSION

Based on the results of this review, factors such as young age, less work experience, work shift, and female gender are considered as strong risk factors for NSI injury in Iran. Preventive measures including education programs can reduce the burden of NSI among healthcare personnel.

Iranian hospital efficiency: a systematic review and meta-analysis

PURPOSE

The purpose of this paper (systematic review and meta-analysis) is to synthesize and analyze studies that assessed Iranian hospital efficiency.

DESIGN/METHODOLOGY/APPROACH

A systematic literature search was conducted using both international (the Institute for Scientific Information, Scopus and PubMed) and Iranian scientific (Magiran, IranMedex and Scientific Information Database) databases. The review included original studies that used the Pabon Lasso Model to examine Iranian hospital performance, published in Persian or English. A self-administered checklist was used to collect data. In total, 12 questions were used for quality assessment.

FINDINGS

In total, 34 studies met our inclusion criteria. The fixed-effects meta-analysis indicated that 19.2 percent (95% confidence interval (CI): 15.6-23.2 percent) of hospitals were in Zone 1 (poor performance: low bed turnover rate (BTR) and bed occupancy rate (BOR) and high average hospital stay (ALoS)), 23.7 percent (95% CI: 20.1-27.8 percent) were in Zone 2, 31.7 percent (95% CI: 27.7-36 percent) in Zone 3 (good performance: high BTR and BOR and low ALoS) and 25.4 percent (95% CI: 21.7-29.5 percent) in Zone 4.

PRACTICAL IMPLICATIONS

Results help Iranian health policymakers to understand hospital performance, which, in turn, may lead to promoting greater awareness and policy attention to improve Iranian hospital efficiency.

ORIGINALITY/VALUE

This study indicated that most Iranian hospitals had sub-optimal performance. Further studies are required to understand factors that explain the country's hospital inefficiency.

Catastrophic healthcare expenditures among Iranian households: a systematic review and meta-analysis

Purpose

Protecting households against financial risks of healthcare services is one of the main functions of health systems. The purpose of this paper is to provide a pooled estimate of the prevalence of catastrophic healthcare expenditures (CHE) among households in Iran.

Design/methodology/approach

Both international (PubMed, Scopus and Clarivate Analytics (previously known as the Institute for Scientific Information)) and Iranian (Scientific Information Database, Iranmedex and Magiran) scientific databases were searched for published studies on CHE among Iranian households. The following keywords in Persian and English language were used as keywords for the search: “catastrophic healthcare costs,” “catastrophic health costs,” “impoverishment due to health costs,” “fair financial contribution,” “prevalence,” “frequency” and “Iran” with and without “health system”. The I2-test and χ2-based Q-test suggested heterogeneity in the reported prevalence among the qualified studies; thus, a random-effects model was used to estimate the overall prevalence of CHE among households in Iran.

Findings

A total of 24 studies with a cumulative sample of 301,097 households were included in the study. The estimated pooled prevalence of CHE among households was 7 percent (95 percent confidence interval: 6–8 percent). Meta-regression analysis indicated that the prevalence of CHE was inversely related to the sample size (p<0.05). The results did not suggest a significant association between the prevalence of CHE and the year of data collection.

Originality/value

The findings revealed that the prevalence of CHE among Iranian households is significantly higher than 1 percent, which is the goal set out in Iran’s fourth five-year development plan. This warrants further policy interventions to protect households from incurring CHE in Iran.

Service quality in Iranian hospitals: A systematic review and meta-analysis

Background: This study aimed to explore service quality in Iranian hospitals by a systematic review and meta-analysis of the existing literature.

Methods: The literature search in the international (PubMed, Scopus, and the ISI) and Iranian (SID, Iranmedex, and Magiran) scientific databases was conducted to identify studies (published in English and Persian) used the service quality gap (SERVQUAL) model to examine service quality in Iranian hospitals between 2000 and 2016. The databases were searched using a combination of the following keywords: "hospital service quality", or "healthcare service quality", and "SERVQUAL model", or "gap model", and "Iran". A random-effects meta-analysis model was used to investigate the quality of hospital care in Iran.

Results: A total of 13 articles with 4,217 patients were included in the study. Results indicate that there are negative gap values between patients' expectations and perceptions in six SERVQUAL dimensions namely. tangibility, reliability, responsiveness, assurance, empathy, and access. The overall mean score of patients’ expectations and perceptions of quality of hospital care in Iran were estimated 4.59 and 3.69, respectively (i.e., quality score gap= -0.9). The highest and lowest quality score gap values were related to the reliability and responsiveness dimensions, correspondingly.

Conclusion: The study found that expectations of patients from hospital care have not been met in Iran. Thus, improving service quality in Iranian hospitals warrants further attention by health professionals, health policy-makers, and hospital managers.

Prevalence of burnout among nurses in Iran: a systematic review and meta-analysis

AIM

This study aimed to summarize the available information in the literature to make an accurate estimate of the prevalence of burnout among Iranian nurses.

BACKGROUND AND INTRODUCTION

Burnout is a work-related stress syndrome that has negative impact on healthcare providers, patients and healthcare delivery systems.

METHOD

A comprehensive search of literature using international [PubMed, Scopus and the Institute for Scientific Information (ISI)] and Iranian scientific data bases [Scientific Information Database (SID), IranMedex and Magiran] was conducted to identify English and Persian language studies, published between 2000 and 2016, that examined the prevalence of burnout among nurses in Iran. The I-squared test and Chi-squared-based Q-test suggested heterogeneity of reported prevalence among the qualified studies; thus, a random-effects model was applied to estimate the overall prevalence of burnout among nurses in Iran.

RESULTS

Based on 21 selected articles with 4180 participants, the overall prevalence of burnout among Iranian nurses was estimated to be 36% [95% confidence interval (CI), 20-53%] in Iran. Meta-regression indicated that sample size and year of data collection, mean age of samples, female to male ratio and geographic regions were not statistically significantly associated with the prevalence of burnout. Also, based on Egger's test and funnel plot, there is no publication bias among studies included in the analysis.

CONCLUSION

Professional burnout affects more than one-third of nursing staff in Iran; thus, effective interventions and strategies are required to reduce and prevent burnout among nurses.

IMPLICATION FOR NURSING AND HEALTH POLICY

Due to the negative consequences of burnout on patients, nurses and organizations, nursing and healthcare managers should intervene to prevent and reduce burnout among nurses in Iran. Policy attention should focus on developing effective interventions to prevent and minimize the burden of burnout among nurses in Iran. Nurses' involvement in the policy-making process is crucial in the implementation of effective programs and initiatives tailored to address the higher prevalence of burnout among Iranian nurses.

Period prevalence and reporting rate of medication errors among nurses in Iran: A systematic review and meta-analysis

AIMS

To estimate the 1-year period prevalence of medication errors and the reporting rate to nurse managers among nurses working in hospitals in Iran.

BACKGROUND

Medication errors are one of the main factors affecting the quality of hospital services and reducing patient safety in health care systems.

METHOD

A literature search from Iranian and international scientific databases was developed to find relevant studies. Meta-regression was used to identify which characteristics may have a confounding effect on the pooled prevalence estimates.

RESULTS

Based on the final 22 studies with 3556 samples, the overall estimated 1-year period prevalence of medication errors and its reporting rate to nurse managers among nurses were 53% (95% confidence interval, 41%-60%) and 36% (95% confidence interval, 23%-50%), respectively. The meta-regression analyses indicated that the sex (female/male) ratio was a statistically significant predictor of the prevalence of medication errors (p < .05), but not of the prevalence of reporting medication errors to nurse managers.

CONCLUSION

The period prevalence of medication errors among nurses working in hospitals was high in Iran, whereas its reporting rate to nurse managers was low.

IMPLICATIONS FOR NURSING MANAGEMENT

Continuous training programmes are required to reduce and prevent medication errors among nursing staff and to improve the reporting rate to nurse managers in in Iran.