Evaluating the disaster preparedness of emergency medical services (EMS) facilities: a cross-sectional investigation in Iran

INTRODUCTION

The preparedness of Emergency Medical Services (EMS) plays a crucial role in managing health disaster risks. This study was conducted to assess the disaster preparedness of EMS facilities in Iran, using a nationally reliable tool.

METHODS

A cross-sectional study was conducted in May 2021 to evaluate the disaster preparedness of EMS facilities in Iran using a national standard tool. The census sampling approach was utilized to select the samples, and descriptive statistics, as well as analytical statistics like the independent t-test and Pearson's correlation test, were used to analyze the data using SPSS-18 software.

RESULTS

The findings of this study revealed that the majority of EMS facilities in Iran possess a moderate level of preparedness in dealing with disasters. Also, the results indicate that EMS facilities have an average level of preparedness against disasters in all dimensions except for "coordination and cooperation" and "surge capacity".

CONCLUSION

According to this study, the majority of EMS facilities in Iran are exposed to different disasters. Furthermore, the findings indicate that while EMS facilities are generally prepared to respond to disasters at an average level, there are some important preparedness gaps in dimensions like response capacities, coordination, and cooperation. Thus, specific strategies, standards, and procedures must be developed and disseminated by the National Medical Emergency Organization.

The impact of Covid 19 pandemic on life satisfaction and health of Iranian bank employees

Background

COVID-19 pandemic has affected various aspects of human life. Bank employees who are more in contact with people are more likely to be infected during the pandemic situation. Moreover, mental, physical and social impacts of COVID-19 are more intense among these employees.Objective: this study aims to determine the effect of COVID-19 pandemic on bank employees' health and life satisfaction in Iran.

Methods

This cross-sectional study was conducted during the fifth wave of COVID-19 from July to October 2021. The population included all the employees of Tejarat Bank in 20 provinces of Iran, 350 of whom were selected using the multi-stage cluster sampling method. The data were collected by demographic questionnaire, 12-item short-form (SF-12) personal health assessment survey and satisfaction with life scale (SWLS). The objective of the study was examined by the structural equation modeling (SEM).

Results

The results showed the two default models of health function (CFI = 0.95) and life satisfaction (CFI = 0.99) had acceptable fit. Assessing the bank employees with COVID-19 revealed this disease had no direct impact on life satisfaction (β = -0.05, P = 0.28) and health function (β = 0.04, P = 0.48). However, it had a direct impact on physical function (β = -0.18, P = 0.001) and, consequently, an indirect impact on life satisfaction. Moreover, low mental function reduced life satisfaction.

Conclusion

COVID-19 infection had no direct impact on life satisfaction. However, it had an indirect and positive impact on it. Considering gender showed COVID-19 infection had a direct and positive impact on life satisfaction among women. The employees who recovered from COVID-19 infection reported higher life satisfaction after returning to work for various reasons than those who never got it.

A qualitative content analysis for determining indexes and factors affecting for evaluation of disaster exercises immediate feedback stage

BACKGROUND

Taking exercise in health sector is one of the important steps to implement the disaster risk management programs, especially preparedness phase. The present study aimed to identify indexes and factors affecting successful evaluation of disasters preparedness exercises in hot wash stage.

MATERIALS AND METHODS

This study was a qualitative content analysis. Data were collected by purposeful sampling through in-depth and semi-structured individual interviews with 25 health professionals in the field of disasters. The data were analyzed using directed content analysis method by which the initial codes were extracted after transcribing the recorded interviews and immersing them in the data analysis. The initial codes were reviewed, classified, and subdivided into several stages to determine the main classes.

RESULTS

The data analysis resulted in the production of 24 initial codes, 5 subcategories, 2 main categories of "evaluation and exercise debriefing" and "modification of programs and promotion of exercise operational functions" under the original theme of "exercise immediate feedback."

CONCLUSION

This study can be considered a suitable standard guide for health care organizations to evaluate successfully disasters exercises in hot wash stage, maintain and promote their preparedness, and properly respond to disasters.

Developing and psychometric testing of the evaluation tool for disaster exercises design stage: A mixed method study

Background

Exercise in different health sectors is an important step in preparing programs for disaster risk management. The present study aimed to develop and validate a tool for evaluating disaster exercises during the design stage in the health sector.

Methods

This methodological study was conducted in two phases using an explanatory sequential mixed method approach. Semi-structured interviews with 25 disaster-related health professionals were conducted during the qualitative phase (item generation), and a systematic review was done to evaluate items pool of disaster exercises design stage tool. The quantitative phase (item reduction) assessed both face and content validity, as well as reliability using Cronbach’s alpha and intra-class correlation coefficient.

Results

At the first stage four main categories and eleven subcategories were extracted from the data, the main categories including "coordination, command and guidance of exercise", "hardware and software requirements of exercise ", "organizational exercise resources", and "communication and exercise public information". The initial items pool included 164 items that were reduced to 50 after the assessment of validity (face and content). Cronbach’s alpha (0.89) and intra-class correlation coefficient (ICC = 0.72) tests indicated that the tool is also reliable.

Conclusion

The research findings provide a new categorization perspective to understand the disaster exercises evaluation in the health sector. The existing 50-item tool can evaluate disaster exercises design stage in the health sector through collecting data with appropriate validity and reliability.

Hospital disaster preparedness in Iranian province: A cross-sectional study using a standard tool

OBJECTIVE

Hospitals are the first place to refer the victims of emergencies and disasters. Hamadan province, as one of the provinces in western Iran, like other parts of this country is exposed to various emergencies and disasters. This study was conducted to evaluate the level of hospital disaster preparedness in the Hamadan province of Iran using a standard tool.

METHODS

This study was conducted in Hamadan province's hospitals in Iran. The Persian version of the World Health Organization Hospital Emergency Response Checklist was used as an evaluation tool. It consists of nine key components: command and control, triage, human resources, communications, surge capacity, logistics/supply management, safety and security, continuity of essential services, and post-disaster recovery. Data entry and analysis were performed using IBM® SPSS® software (version 18).

RESULTS

Fifteen hospitals participated in this study (response rate 83 percent). Most hospitals (53.33 percent) were in moderate preparedness level, 26.66 percent are in good, and 13.33 percent are at a poor level. There was no significant relationship between "the hospital type" and "the hospital size" (number of beds) and preparedness score (p > 0.05).

CONCLUSIONS

This study showed that most of the hospitals in the Hamadan province regarding the components of "logistics" and "essential services" are at a poor disaster preparedness level. Accordingly, the hospital authorities and managers must adopt a comprehensive strategy for strengthening the hospital disaster preparedness measures, especially in these components.

COSMIN Checklist for Systematic Reviews of the Hospital Preparedness Instruments in Biological Events

BACKGROUND AND PURPOSE

The purpose of this research was to evaluate the psychometric properties of hospital preparedness instruments in biological events. The Consensus-based Standards for the selection of health Measurements Instruments (COSMIN) checklist has been used to design the appropriate hospital preparedness instruments in these events.

METHODS

A systematic search was performed in PubMed, Scopus, Web of Science and ProQuest, Google Scholar for relevant literature until December 31, 2018, and the data were extracted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of the identified studies was assessed per measurement property according to the COSMIN checklist. Twenty studies that met the inclusion criteria were included.

RESULTS

The result showed that none of the evaluated checklists and instruments included all dimensions required for an appropriate hospital preparedness evaluation. The results revealed that none of the included studies reported adequate information on all the measurement properties of the instruments studied as per the COSMIN criteria.

CONCLUSIONS

The information on their measurement properties was lacking. Thus, there was a need for evaluating measurement. However, a vital necessity is felt for developing an instrument with acceptable psychometric properties for measuring hospital preparedness in biological events. The present study provided improved clarity about the quality of currently available hospital preparedness instruments in the biological event and the results of this systematic review could be used to prepare a standardized instrument to evaluate hospital preparedness in biological disaster.

Shift working disorders among nurses of Tehran hospital and its related factors in 2016

INTRODUCTION

Many adverse effects occur among the nurses due to shift work Hence, the present study aimed to determine the prevalence of shift work-related disorders and its related factor among the nurses at Tehran University Subsidiary Hospital, Iran, and to find solutions for managing the relevant health problems.

METHODS

In this cross-sectional study, the Survey of Shift workers (SOS) questionnaire and the Personal Information Form were used to collect data related to demographics and working conditions of 1259 randomly selected nurses working at Tehran University Subsidiary Hospital as statistical population.

RESULTS

According to the results, psychological disorders (95%), digestive problems (85%) and social problems (80%) were the most frequent problems among the subjects. Additionally, the satisfaction rate was higher among the volunteer nurses compared to nurses who were forced to do shift work (P < 0.05).

CONCLUSION

The nurses volunteered for shift work had higher satisfaction rate compared to nurses forced to shift work system; moreover, they had more job satisfaction and less shift work-related complaints. Therefore, it is important to select the nurses who are volunteer for shift work system. In addition, the shift work schedule in hospitals should be set based on workload and requirements because the shift schedule can adversely influence the social and family issues of the nurses, as well as their sleep quality and body biological process.

Safety climate and related factors in rehabilitation nurses of hospitals in Iran

BACKGROUND

Safety climate is a common insight of staff that indicates individuals' attitudes toward safety and priority of safety at work.

OBJECTIVES

Nursing is a risky job where paying attention to safety is crucial. The assessment of the safety climate is one of the methods to measure the safety conditions in this occupation. The aim of this study was to assess the safety climate of rehabilitation nurses working in hospitals in Tehran.

METHODS

This is a cross-sectional study which was carried out on 140 rehabilitation nurses selected from all hospitals and clinics in Tehran in 2019. To collect the required data, a two-section questionnaire was used. The first section was related to demographic factors and the second part (22 statements) was to measure the safety climate using nurses' safety climate assessment questionnaire. The collected data were analyzed by SPSS V16 using independent t-test, ANOVA, Kruskal-Wallis and Mann-Whitney U test at the 5% level.

RESULTS

Findings showed that the total mean of safety climate was 3.06±0.56. According to the results, a significant difference was found between the positive and negative satisfaction of nurses with safety climates (P-value = 0.03), communication with nurses (P-value = 0.01) and supervisors' attitude (P-value = 0.02). Furthermore, a significant difference in safety climate between the individual with the second job and the individual without second could be observed (P-value = 0.01).

CONCLUSIONS

The results indicated that the safety climate was not at an acceptable level. Thus, it is essential to introduce safety training courses (e.g. safety, work-rest balance, and so on) and to improve the safety performance at work.

The prevalence of metabolic syndrome in drivers: A meta-analysis and systematic review

BACKGROUND

Metabolic syndrome is an increasing disorder, especially in night workers. Drivers are considered to work during 24 hours a day. Because of job characteristics such as stress, low mobility and long working hours, they are at risk of a metabolic syndrome disorder.

OBJECTIVES

The purpose of this study is a meta-analysis and systematic review of the prevalence of metabolic syndrome in drivers.

METHODS

In this systematic review, articles were extracted from national and international databases: Scientific Information Database (SID), Iran Medex, Mag Iran, Google Scholar, Science Direct, PubMed, ProQuest, and Scopus. Data analysis was performed using meta-analysis and systematic review (random effect model). The calculation of heterogeneity was carried out using the I2 index and Cochran's Q test. All statistical analyses were performed using STATA software version 11.

RESULTS

A total of nine articles related to the prevalence of metabolic syndrome in drivers in different regions of the world from 2008 to 2016 were obtained. The total sample size studied was 26156 with an average of 2906 samples per study. The prevalence of metabolic syndrome in drivers was 34% (95% CI: 30-37)CONCLUSIONS:According to the results of this study, the prevalence of metabolic syndrome in drivers is high. Occupational stress, unhealthy diet and physical inactivity cannot be cited as causes of metabolic syndrome prevalence in drivers. Therefore, to maintain and to improve the health of this group, the implementation of preventive, therapeutic and rehabilitation measures for these people as well as training should be considered.

Investigation of Relationship between Occupational Stress and Cardiovascular Risk Factors among Nurses

Background:

One of the major causes of various work-related health problems among nurses is occupational stress. Hence, the main purpose of the present research was to find association between occupational stress of nurses and risk factors of cardiovascular disease.

Methods:

In this cross-sectional study, the Osipow job stress questionnaire was employed to assess the occupational stress among the 250 nurses in Emam Khomeini hospital of Tehran in 2018. Based on stress score for participants, subjects divided into two groups: Scoring of group one was 60–179 (mild and average stress) and group two between 180 and 300 (average to acute and acute stress). Systolic and diastolic blood pressures were recorded for subjects after 10hrs fasting. Then the blood samples were collected to measure cholesterol, triglyceride and glucose levels. For determining the association between education level, job experience and study groups, the Chi-square test and for comparing job stress between two groups of study the Mann–Whitney U test was used.

Results:

Subjects with job stress in group one was 70(28%) and group two was 180(72%). The association between level of education and two study groups was not significant (P=0.129) while between job experience and two study groups was significant (P=0.004). Mean of Blood glucose levels for group I (98.0± 37.5), was higher than group II (82.5±12.0) and statistically significant (P=0.001). No significant difference was found between two groups of study for other parameters.

Conclusion:

High level of work-related stress among subjects affected the values related to blood glucose level, but no significant relationship was found between other risk factors of cardiovascular diseases and occupational stress among nurses.

Migration health crisis associated with climate change: A systematic review

BACKGROUND

The empirical assessment of the health outcomes associated with migration caused by climate change is still unclear. However, health outcomes in the early stages are expected to be similar to the health outcomes associated with refugees. The objective of the present study was a systematic review of the health effects of migration caused by climate change.

METHODOLOGY

A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Online databases (PubMed, Scopus, Web of Science, and Google Scholar) were used to identify papers published that evaluated the health effects of migration caused by climate change. The search, article selection, and data extraction were carried out by two researchers independently. All English-language articles on the health effects of migration caused by climate change were included in this study.

RESULTS

An analysis of the complex ways in which climate change influences populations can be facilitated using a three-class classification: compulsory displacement, resettlement planning, and migration. Subsequent to climate changes, other changes, and environmental deficiencies, compulsory displacement may occur in case of inadequacy of compatibility responses. A part of migration-related health outcomes caused by climate change is from displacement from rural to urban areas, especially in developing countries. There is significant documentation on health and livelihood inequalities between migrant groups and host populations in developed countries.

CONCLUSION

If climate change continues in its current direction, it is likely that the number of refugees and crises will increase in the coming decades. Although the domain and the extent of health hazards caused by the displacement of the population associated with climate change cannot be clearly predicted, by reducing global greenhouse gas emissions, along with social and environmental adaptation strategies, migration caused by climate change, health risks and its relevant crises can be greatly reduced.

Investigation of the Relationship between Trauma, Anxiety, Depression and Stress in Kerman Emergency Medical and Emergency Center 115

Introduction: The efficacy of psychological and pharmacological approaches is broadly similar in the acute treatment of psychopharmacology disorders. One of the most important stressful environmental stimuli that can cause chronic stress is people's jobs. And since promoting the mental health of individuals in a society, especially its constituent classes, is essential to the dynamics and growth of that society, this research was conducted with the aim of investigating the relationship between trauma caused by accident and anxiety, depression, and stress in Kerman Emergency Medical and Emergency Center during 2019. Methods: This is a descriptive-correlational study. The statistical population was all 70 personnel members of Emergency Medical and 115 Emergency Centers in Kerman. The Depression, Stress and Anxiety Scale 21 and Trauma Screening were used as the instruments of measurement. Pearson and Spearman correlation coefficients through SPSS software were used to test the hypotheses. Results: There is a significant and direct correlation between trauma caused by accidents and personnel anxiety with a correlation coefficient of 0.407. Also, there is a significant and direct correlation between trauma caused by accidents and personnel depression with a correlation coefficient of 0.407. There is also a significant and direct relationship between trauma caused by accidents and personnel stress with a correlation coefficient of 0.388. Conclusion: Our data suggested that mental health along with personality traits is a solution to reduce stress and anxiety resulting from the personnel facing trauma caused by accidents.

The effect of education and implementation of "National Hospital Disaster Preparedness Plan" on an Iranian hospital preparedness: An interventional study

INTRODUCTION

Hospitals as the first place for injuries have to keep up and increase activities in emergency and disasters. Therefore, any hospital necessarily requires disasters plan to improve its preparedness. The aim of this study is to investigate the effect of education and implementation of "National Hospital Disaster Preparedness Plan (NHDPP)" on Vali Asr Hospital preparedness in Iran.

METHODOLOGY

In a pre- and post-intervention study, NHDPP educated in five sessions, and it was used as a guide in the promotion of Vali Asr Hospital preparedness in Iran. The Iranian version of "Hospital Disaster Preparedness (HDP) assessment tool" was used to measure the hospital preparedness score. Finally, the quantitative data analyzed by using IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.

RESULTS

Before intervention, the HDP score was measured in total and in the nine dimensions of preparedness. But after the intervention, it increased, 33% in command and control dimension, 33% in communication, 21% in safety and security, 26% in triage, 36% in surge capacity, 24% in the continuity of vital services, 27% in human resources, 13% in support and supplies management, and 7% in post disaster recovery dimension. Furthermore, the total HDP score increased about 24.5% after the intervention.

CONCLUSION

This study demonstrates that the "Iranian HDP plan" leads to improve the Vali Asr HDP score. Therefore, by planning and implementation of effective educational programs, it is possible to improve the hospitals' preparedness in Iran.

Hospital management preparedness tools in biological events: A scoping review

INTRODUCTION

The objective of the present study was to systematically review the current research knowledge on hospital preparedness tools used in biological events and factors affecting hospital preparedness in such incidents in using a scoping review methodology.

MATERIALS AND METHODS

The review process was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guideline. Online databases (PubMed, Scopus, Web of Science, and Google Scholar) were used to identify papers published that evaluated instruments or tools for hospital preparedness in biological disasters (such as influenza, Ebola, and bioterrorism events). The search, article selection, and data extraction were carried out by two researchers independently.

RESULTS

A total of 3440 articles were screened, with 20 articles identified for final analysis. The majority of research studies identified were conducted in the United States (45%) and were focused on CBRN incident (20%), Ebola, infectious disease and bioterrorism events (15%), mass casualty incidents and influenza pandemic (10%), public health emergency, SARS, and biological events (5%). Factors that were identified in the study to hospitals preparedness in biological events classified in seven areas including planning, surge capacity, communication, training and education, medical management, surveillance and standard operation process.

CONCLUSIONS

Published evidences of hospital preparedness on biological events as well as the overall quality of the psychometric properties of most studies were limited. The results of the current scoping review could be used as a basis for designing and developing a standard assessment tool for hospital preparedness in biological events, and it can also be used as a clear vision for the healthcare managers and policymakers in their future plans to confront the challenges identified by healthcare institutes in biologic events.

Comparing the effects of two different educational methods on clinical skills of emergency intermediate technician: A quasi-experimental research

BACKGROUND

Assessing the clinical skills of prehospital Intermediate technician is considered to be one of the priorities in dealing with diseases, which may provide an appropriate reflection of the training programs. The purpose of this study was to compare the two methods of clinical skills training of emergency intermediate technician.

METHODS

This quasi-experiment was carried out on Kerman's emergency medical technicians in 2017. Operational and clinical skills, such as cardiopulmonary resuscitation (CPR), triage, familiarity with the equipment, and proper patient transportation methods, were taught in both electronic and traditional methods on two groups, each consisting of 30 intermediate technicians. Finally, the personnel's satisfaction level with the two teaching methods was compared and analyzed using IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.

RESULTS

There was no significant difference between the theoretical test scores in both the electronic and traditional methods in all the participants (triage, pulmonary resuscitation, familiarity with equipment, and patient transportation). Furthermore, there were significant differences between the practical test scores in both the electronic and traditional methods, in all the participants except triage. There was a significant difference between learners' satisfaction in both electronic and traditional methods in two areas of teaching and course difficulty in CPR, equipment usage, and methods of transportation.

CONCLUSION

According to the results obtained by the present study, the electronic educational systems due to their inclusive and interactive nature are recommended to be employed in courses that have more theoretical aspects such as triage. The traditional method is suggested in teaching practical courses such as CPR that need more practical and clinical skills.

Motivation of the nurses in pre-hospital emergency and educational hospitals emergency in the southeast of Iran

INTRODUCTION

Nurses, as the largest human resource element of health care systems, have a major role in providing ongoing, high-quality care to patients. Therefore, due to the importance of this issue, this study aimed to determine job motivation of the nurses in pre-hospital and educational hospitals emergency in the southeast of Iran.

METHODS

In this study, a cross-sectional method was used, and it was conducted in educational hospitals and pre-hospital emergencies under supervision of the Kerman University of Medical Sciences in 2017. Using a valid and reliable questionnaire, we assessed job motivation of the nurses using a census method (N = 275). Data were analyzed by implementing descriptive statistics including mean and standard deviation (SD), and analytical statistics such as Kolmogorov-Smirnov, ANOVA, t-test, X2, Pearson, and multivariate regression tests using SPSS 16 and P ≤ 0.05.

RESULTS

Among the pre-hospital emergency nurses, the average of the educational factors was 25.33, financial factors was 6.34, psychological factors was 20.07, welfare factors was 0.63, and administrative factors was 8.16. Among the nurses of the educational hospitals emergency, these factors were 25.33, 6.51, 20.34, 16.55, and 8.39, respectively. Two group's nurses were at the intermediate level of the job motivation.

CONCLUSION

Dynamic and predetermined goals of emergency include providing services as soon as possible and stabilizing patient's condition during the golden and vital time of rescue. Findings suggest that national and local policies in Iran may need to examine factors that contribute to the promotion of the motivation as well as focusing on how to improve them.