Public Hospital Management Research Articles

Effect of Self-Determination Theory (SDT) Elements on the Retention of Nurses at the University of Calabar Teaching Hospital (UCTH), Calabar, Nigeria

This research investigated the effect of self-determination theory (SDT) elements on the retention of nurses at the University of Calabar Teaching Hospital (UCTH) in Calabar, Nigeria. The primary focus was to analyze how SDT components like autonomy, competence, and relatedness influence nurse retention at UCTH. Utilizing a cross-sectional research design, the study collected primary data via structured questionnaires from 206 general nurses at UCTH. Descriptive statistics were used to analyze the data, and multiple regression was employed to test the hypotheses. The results indicated that SDT factors—autonomy, competence, and relatedness—had significant positive effects on nurse retention at UCTH. These results underscore the critical importance of nurturing self-determination motivation elements in public hospitals like UCTH to improve nurse retention. Therefore, the study advised that public hospital managers in Nigeria should establish a supportive work environment that promotes nurses' independence in patient care and evaluation. It is also essential to prioritize continuous training and skill enhancement to elevate technical proficiency and the quality of patient care. Furthermore, fostering a culture of social interaction and professional relationships among staff is key to boosting nurses' sense of belonging and worth in the workplace. The study also highlighted the need for extensive research to gain a deeper understanding of the link between SDT factors and employee retention in Nigerian healthcare. Future research should encompass other healthcare professionals in addition to nurses to offer comprehensive insights for effective retention strategies in the Nigerian public health sector.

Nurses′ knowledge and practice about neonatal pain management in public hospitals in West Oromia, Ethiopia, 2022: multi-centered cross-sectional study

BackgroundIn low-and middle-income countries inadequate neonatal pain management persists as a significant public health issue despite the availability of guidelines. Newborns often experience pain from routine medical and surgical procedures, with limited nurses’ knowledge and suboptimal practices posing common obstacles to effective neonatal pain management in hospital settings. Hence, this study aimed to evaluate nurses’ knowledge and practices related to neonatal pain management and the factors influencing them in public hospitals in West Oromia, Ethiopia, in 2022.MethodsA multicenter cross-sectional study was conducted among 203 nurses working in public hospitals in West Oromia from 8th May-6th June 2022. Data was gathered using structured, self-administered questionnaire and sampled through simple random sampling. The collected data were coded and entered into a computer using Epi-Data version 4.6 Statistical Software. They were analyzed using the Statistical Package for Social Science (SPSS; IBM Corporation) version 26. Binary logistic regression was used to identify significant independent variables at p < 0.05.FindingsIn this study, 127 (62.6%) exhibited adequate knowledge, while 33 (16.3%) nurses demonstrated good practice in neonatal pain management. Attending lectures or receiving training about neonatal pain management was found to be significantly associated with nurses’ knowledge of neonatal pain management [AOR, 2.31, 95%CI; 1.29–4.27]. On the other, having adequate knowledge of neonatal pain management [AOR, 3.3, 95%CI; 1.14–9.32]; the presence of a pain management policy in place [AOR, 5.44, 95% CI; 1.92–15.37] and attending lectures on neonatal pain management [AOR, 2.55, 95% CI; 1.09–5.97] were found to be significantly associated to nurses’ practices.ConclusionGiven the substandard level of nurses’ practice in neonatal pain management. It is suggested to enhance the nurses’ knowledge and practice about neonatal pain management by providing refreshment courses, training sessions, or facilitating nurses’ opportunity access to reading resources about neonatal pain management.

Impact of clinical pathway implementation satisfaction, work engagement, and hospital-patientrelationship on quality of care in Chinese nurses.

This study aimed to investigate how clinical pathway implementation satisfaction, work engagement, and hospital-patient relationship impact the quality of care that is provided by nurses in public hospitals. Clinical pathways are recommended as a form of quality improvement by broader healthcare systems and are widely used in the world. Nurses are the most involved group of healthcare professionals in the implementation of clinical pathways in public hospitals. So, it is important to investigate how their satisfaction with the process affects the quality of care they provide and influencing factors. This descriptive cross-sectional study surveyed nurses practicing across seven tertiary public hospitals in Sichuan Province, China, online. The survey consisted of a questionnaire for the general characteristics of the participants and four Chinese maturity scales validated by previous studies: clinical pathway implementation satisfaction scale, work engagement scale, hospital-patientrelationship perception scale, and quality of care scale. The bootstrap method was used to test a moderated mediation model using Hayes' PROCESS macro models 4 and 8. We followed STROBE guidelines to prepare the study report. A total of 880 nurses filled out the questionnaires, 821 of which were regarded as valid. Clinical pathway implementation satisfaction had a positive effect on quality of care (B=0.873, P<0.001). Work engagement played a mediation role between nurses' clinical pathway implementation satisfaction and the quality of care (effect=0.080, Boot 95% CI=[0.023, 0.142]). This mediation model was moderated by the hospital-patientrelationship (P < 0.01). Clinical pathway implementation satisfaction may enhance the quality of care by work engagement of nurses. Moreover, a good hospital-patientrelationship can enhance the positive impact of nurses' satisfaction on work engagement and health service quality. Public hospital managers need to pay attention to nurses' evaluation of and perceptions toward clinical pathway implementation and then take corresponding measures to improve their satisfaction to enhance the quality of care. At the same time, the government, society, and hospitals also need to foster good hospital-patient relationships to ensure that nurses have a high level of work engagement that aids in providing high-quality care services.

The use of dashboards and performance management in public hospitals: the case of Togo

The use of dashboards and performance management in public hospitals: the case of Togo

Satisfaction with clinical pathway implementation versus job performance of clinicians: empirical evidence on the mediating role of work engagement from public hospitals in Sichuan, China

BackgroundThe job performance of clinicians is a clear indicator of both hospital capacity and the level of hospital service. It plays a crucial role in maintaining the effectiveness and quality of medical care. Clinical pathways are a systematic method of quality improvement successfully recommended by broader healthcare systems. Since clinicians play a key role in implementing clinical pathways in public hospitals, this study aims to investigate the effect of the satisfaction of clinicians in public hospitals with clinical pathway implementation on their job performance.MethodsA cross-sectional study design was used. Questionnaires were administered online. A total of 794 clinicians completed the questionnaires in seven tertiary public hospitals in Sichuan Province, China, of which 723 were valid for analysis. Questionnaires contained questions on social demographic characteristics, satisfaction with clinical pathway implementation, work engagement, and job performance. Structural Equation Model (SEM) was used to test the hypotheses.ResultsThe satisfaction of clinicians in public hospitals with clinical pathway implementation was significantly positively correlated with work engagement (r = 0.570, P < 0.01) and job performance (r = 0.522, P < 0.01). A strong indirect effect of clinicians’ satisfaction with clinical pathway implementation on job performance mediated by work engagement was observed, and the value of this effect was 0.383 (boot 95%CI [0.323, 0.448]).ConclusionThe satisfaction of clinicians in public hospitals with clinical pathway implementation not only directly influences their job performance, but also indirectly affects it through the mediating variable of work engagement. Therefore, managers of public hospitals need to pay close attention to clinicians’ evaluation and perception of the clinical pathway implementation. This entails taking adequate measures, such as providing strong organizational support and creating a favorable environment for the clinical pathway implementation. Additionally, focusing on teamwork to increase clinicians’ satisfaction can further enhance job performance. Furthermore, managers should give higher priority to increasing employees’ work engagement to improve clinicians’ job performance.

Value Commitment Influence on Turnover Intention, Mediated by Organizational Culture among Health Professionals in National Referral Hospitals in Kenya

The study aimed to determine the influence of value commitment on turnover intention among health professionals of public national referral hospitals in Kenya. Further, the study examined whether organizational culture mediates the effect of value commitment on the turnover intention of health professionals in public national referral hospitals in Kenya. The research designs used were descriptive and correlation. The designs assessed the relationship, effect, and mediation, where value commitment's influence on turnover intention and organizational culture mediation of value commitment's effect on turnover intention was tested. Theories that anchored this study included organizational support theory and theory Z. The Target population was all health professionals in public national referral hospitals in Kenya. The study used SPSS version 25 for scale accuracy. The findings of the study indicated that the value commitment relationship was significant. Value commitment and organizational culture relationships were also significant. The study found that organizational culture-mediated value commitment affects turnover intention. The study concluded that value commitment influences turnover intention among Kenya's health professionals in public national referral hospitals. It was also concluded that the effect of value commitment on turnover intention was mediated by organizational culture. The study recommended that boards of management in public national referral hospitals set standard operating policy that improves value commitment goals. Human resource managers should come up with practices that enhance the attitude change of employees to see that organizations succeed in achieving their goals. National Assembly should come up with a curriculum that trains health professionals on value commitment tenets that improve the performance of long-serving employees.

Investigating the Mediating Role of Unlearning in the Relationship between Organizational Culture and Knowledge Management in Public Hospitals of Iran

Investigating the Mediating Role of Unlearning in the Relationship between Organizational Culture and Knowledge Management in Public Hospitals of Iran

Optimization Path for Management Decision-Making&amp;nbsp;of Chinese Public Hospitals Under the Background of Big Data

This study examines how Big Data might improve Chinese public hospital management. A comprehensive study examines how data diversity, storage efficiency, analytics tools, and information system complexity affect decision-making. A carefully selected quantitative dataset from Chinese public hospitals is used in the study. Analyses use structured medical records, semi-structured billing data, and unstructured patient comments. The sample size of 115 was chosen for statistical robustness and multiple regression analysis best practices, which recommend 10-20 observations per predictor variable for estimate. Multiple linear regression analysis highlights amazing correlations and stresses data diversity, storage efficiency, analytics tools, and information system sophistication in decision efficiency. The study helps healthcare executives and regulators understand the complex relationship between regression coefficients and modified R-squared value. Also evaluated are Chinese public hospitals' strengths and weaknesses. Strengths include data integration, analytics, and advanced information systems. The report emphasizes data quality and cultural transformation, which impact Big Data and decision-making. The report emphasizes data consumption and advanced analytics to empower healthcare decision-makers. This research informs Chinese public hospital strategic reforms to improve resource allocation, patient care, and efficiency. This paper demonstrates how Big Data can impact healthcare decision-making. It enriches academic discourse and guides healthcare stakeholders through modern management with relevant insights and practical advice.

Effects of medical consortium policy on health services: an interrupted time-series analysis in Sanming, China.

China has implemented reforms to enhance the operational efficiency of three-level medical services through medical consortiums (MCs). This study evaluated the impact of MCs reform on health services in Sanming, China. An interrupted time-series analysis (ITSA) was conducted to assess the impact of MCs on changes in health service levels and trends across the overall situation of MCs and different institutional types within MCs, including county hospitals and grassroots medical institutions. The evaluation focused on various indicators such as outpatient and emergency visits, inpatients, average length of stay, occupancy rate of hospital beds, and hospital bed turnover times. Monthly data were collected from April 2015 to June 2019 through reports on the Sanming Municipal Health Commission website and the Sanming public hospital management monitoring platform. After the intervention of MCs reform, a significant increase was observed in the total number of inpatients (β3 = 174.28, p < 0.05). However, no statistically significant change was observed in the total number of outpatient and emergency visits (β3 = 155.82, p = 0.91). Additionally, the implementation of MCs reform led to an amplification in service volumes provided by county hospitals, with significant increases in the number of outpatient and emergency visits (β3 = 1376.54, p < 0.05) and an upward trend in the number of inpatients (β3 = 98.87, p < 0.01). However, no significant changes were observed under the MCs policy for grassroots medical institutions regarding the number of outpatient and emergency visits (β3 = -1220.72, p = 0.22) and number of inpatients (β3 = 75.42, p = 0.09). The Sanming MCs reform has achieved some progress in augmenting service volumes. Nevertheless, it has not led to an increase in service volumes at the grassroots medical institutions. There persists an insufficiency in the efficiency of services and a need for further improvement in primary healthcare. To address these concerns, it is imperative for county hospitals to offer targeted assistance that can enhance motivation among grassroots medical institutions. Besides the MCs should explore initiatives, including improved management of medical equipment, allocation of funding, and personnel resources.

Analysis of the Forces Driving Public Hospitals’ Operating Costs Using LMDI Decomposition: The Case of Japan

The sustainable management of public hospitals is usually threatened by long-term operating deficit, which was exacerbated during the COVID-19 pandemic. This study aimed to quantitatively decompose the historical changes in the annual operating costs of public hospitals in Japan to identify the main driving forces responsible for a worsening imbalance between operating costs and income over the past two decades. A dataset of the annual operating costs of public hospitals in Japan was compiled, in which influencing factors were redefined to make the data amenable to the application of a decomposition method referred to as the Logarithmic Mean Divisia Index (LMDI). Using the LMDI method, the contribution of each influencing factor to the changes in public hospital operating costs was quantitatively determined. The results indicate that, on average, there is an annual reduction in operating costs by JPY 9 million per hospital, arising out of the national reform of public hospitals, but the rapid increase in the prices and worsened structure of costs in recent years resulted in an annual increment of JPY 127 million per hospital to the increasing operating costs. The pandemic revealed damage to the financial balance of public hospitals, but epidemic prevention policies brought an offset to the increased operating cost. A more resilient domestic medical supply chain, the introduction of new technologies, and continuous endeavors in system reform and pricing policies are required to achieve financial sustainability in public hospitals in Japan.

Digital Transformation in Public Hospital Management: Improving the Patient Experience

Purpose: This article aims to investigate the impact of digital transformation on public hospital management in Peru, with a specific focus on enhancing the patient experience through the adoption of digital technologies. Objective: The primary objective is to assess the effectiveness of digital transformation strategies in improving the efficiency and accessibility of health services in public hospitals, ultimately aiming to enhance the overall patient experience. Theoretical Reference: The study is grounded in a mixed-method approach, incorporating elements of qualitative and quantitative research. It includes a comparative analysis of digital transformation strategies implemented in a representative sample of public hospitals at international, regional, and national levels. Method: The research design involves in-depth interviews with healthcare professionals and patients, as well as the analysis of secondary data from national and international health databases. The study encompasses a diverse sample of public hospitals, considering varying technological capabilities and levels of digital development. Results and Conclusion: The findings indicate that the progressive implementation of digital technologies in public hospitals in Peru has shown promise in improving the efficiency and accessibility of health services. However, challenges related to infrastructure, systems integration, and data security remain. The study underscores the need for a comprehensive and coordinated strategy for digital transformation in public hospital management. Implications of Research: The study highlights the importance of greater investment and development of digital health policies at the national level to bridge the gap in the adoption and implementation of digital technologies in hospital management. It emphasizes the significance of a collaborative approach between government, healthcare providers, and technology developers to drive digital transformation in the healthcare sector in Peru. Originality/Value: This research contributes to the understanding of the potential of digital transformation in public hospital management, particularly in developing countries like Peru. It provides insights into the challenges, opportunities, and implications of implementing digital technologies to enhance the patient experience and improve healthcare delivery in public hospitals.

Current Screening and Management Practices for Gestational Diabetes Mellitus in Public Hospitals of South India

Background Gestational Diabetes Mellitus GDM leads to adverse maternal and foetal health outcomes. There are several benefits of screening pregnant women for GDM including reducing the impact and timing of GDM-associated complications. However there is limited evidence regarding GDM screening and management in public hospitals in low- and middle-income countries. Therefore we aimed to understand the current GDM screening and management practice in public hospitals in South India through the study of pregnant women in Bangalore.Methods We conducted a cross-sectional study in all the six tertiary-level public hospitals of Bengaluru which were providing antenatal services during September 2017. We compared the results of GDM screening in five of these hospitals with a tertiary public hospital wherein a cohort of women were studied during the same time wherein voluntarily consented women were subjected to GDM screening and were followed up through their pregnancy and post-partum.Results Among the 186 pregnant women included in the cross-sectional study 41.4 n77186 had undergone random blood sugar test and 22 n39186 underwent a confirmatory test in the form of either a Glucose Challenge Test GCT or Oral Glucose Tolerance Test OGTT for diagnosis. Similarly pregnant women underwent capillary blood glucose testing 5.1 n9186 fasting blood sugar 1.7 n3186 urine glucose and albumin level 1.7 n3186 testing. The prevalence of GDM in this cross-sectional study obtained via routine screening in public hospitals was 4.3 n8186 while in comparison the prevalence of GDM was 15.4 n1571019 in the ongoing cohort. Furthermore only 22.9 of cohort women diagnosed with GDM received any follow-up treatment in public hospitals. We also found that 12.1 and 7 of women achieved glucose control in the antenatal and postnatal period respectively.Conclusion Our results suggest that most women with GDM attending public hospitals may be ldquomissedrdquo from GDM diagnosis and treatment even in the major public hospitals in Bangalore. Therefore strengthening the GDM screening and management in public hospitals is imperative to avert the adverse risks of GDM among women and their children in urban areas.

Ranking Competencies of Managers with the Combined Method of Dimtel and Network Analysis (Case study: Public Hospitals of Yazd Province)

Background: The success of any organization depends on the expertise and competence of human resources, especially its managers. Competence is defined as the knowledge and skills necessary to perform a job. The current study aimed to rank the competencies of managers based on the competence model of Dolewis and Higgs (2005), which was carried out using multi-criteria decision-making techniques (combined method of Dimtel and network analysis) in public hospitals of Yazd province.&#x0D; Methods: This inductive approach research was carried out quantitatively during 2021 to 2022 in public hospitals of Yazd province. In this study, multi-criteria decision-making techniques were used including the combined method of Dimtel and network analysis. The statistical population was a group of human resources experts and senior managers of public hospitals in Yazd province. Sampling was done first by judgment and then by snowball method and through the introduction of experts and based on the possibility of access to them, and 15 experts were selected as a sample. After extracting the data from the experts' questionnaires, Dimtel method was used to evaluate the relationships between the indicators.&#x0D; Results: In the current study, according to the experts’ opinions, the competence model of Doleviz and Higgs (2005) was considered, which included three managerial, personal, and intellectual dimensions. The dimension of managerial competence included components of success, empowerment, development, engaging and effective communication, resource management. The dimension of intellectual competence included components of judgment and critical analysis, perspective and foresight of strategic views. The dimension of personal competence included components of self-awareness and emotional resilience, intuitive understanding, interpersonal sensitivity, influence, motivation, and conscience. Based on the results of the super matrix of network analysis, the weights of competence in order of priority included managerial, intellectual, and personal competence. In managerial competence, the component of resource management, in personal competence, the influence component, and in intellectual competence, the components of foresight and perspective were more important.&#x0D; Conclusion: In order to be more successful in achieving future goals and perspective, hospital managers should strive to strengthen their competencies, since improving the competence of managers helps them in effective use of resources, better response to clients, and achieving goals, in accordance with the accreditation standards of public hospitals in Yazd province

Analysis of the Current Situation in Chinese Public Hospital Based on AMO Theory

Public hospitals in China have a complicated internal structure with a sizable number of members and a strict management system. Human resource management plays an important part in the management of modern public hospitals, which also serves as the primary management component for efficient internal management. At the same time, in the context of strategic human resources management, the AMO theory has gradually entered the management of public hospitals. Based on a brief overview of human resource management in modern public hospitals, this study adopts the AMO theory (abilities, motivations, and opportunities) perspective in analysing the problems and challenges faced by the human resource management strategy in modern public hospitals, and exploring how human resource management in modern public hospitals should play an effective role based on the AMO theory. Based on a detailed and targeted analysis of the contents of the challenges, theoretical and practical support for the development of modern hospitals and the orderly conduct of internal management is provided.

Neonatal pain management practice in the neonatal intensive care unit of public hospitals: a survey of healthcare providers in eastern Ethiopia.

Newborns experience multiple painful and stressful procedures during their hospitalization in neonatal intensive care units (NICUs). Repeated or untreated pain can have negative consequences for the health and development of newborns. Despite the growing knowledge of pain assessment and intervention, several studies have shown that the practice of neonatal pain management among healthcare providers is poor. Therefore, data regarding neonatal pain management practice and affecting factors are essential for taking appropriate actions. This study assessed neonatal pain management practice and associated factors among healthcare providers working in the NICUs of public hospitals in eastern Ethiopia from 1 January to 28 February 2022. An institution-based cross-sectional study design was used among 372 randomly selected healthcare providers working in the NICUs of public hospitals in eastern Ethiopia. Data were collected using a pre-tested structured self-administered questionnaire and an observation checklist. The collected data were reviewed, coded and entered into Epi-data version 3.1 and exported to SPSS version 25 for analysis. Bivariate and multivariable logistic regression were used to identify the associations between outcome and predictor variables at a 95% confidence level and P-values <0.05 were considered statistically significant. The study found that 185 (53.9%; 95% confidence interval [CI] 48.4 to 59.2) of the 343 respondents had good neonatal pain management practice with a mean of 11.38 (standard deviation 3.64). Receipt of in-service training in neonatal pain management (adjusted odds ratio [AOR] 2.12 [95% CI 1.15 to 3.91]), availability of protocols and guidelines in the NICUs (AOR 2.94 [95% CI 1.74 to 4.91]) and accessibility of analgesics in the NICUs (AOR 4.302 [95% CI 2.46 to 7.53]) were significantly associated with good neonatal pain management practice. The overall practice of healthcare providers in neonatal pain management in public hospitals in eastern Ethiopia is relatively high compared with previous studies conducted in Ethiopia. Improving the availability of analgesics as well as neonatal pain management protocols and guidelines in NICUs will aid in the promotion of good neonatal pain management practices. In addition, providing ongoing in-service training on neonatal pain management will allow healthcare providers to better care for newborns in pain.

Identifying and prioritizing the key performance indicators for hospital management dashboard at a national level: Viewpoint of hospital managers.

Participation of main users in identifying key performance indicators (KPIs) for management dashboards contributes to their success. The aim of this study was to identify and prioritize the KPIs of hospital management dashboards from the viewpoint of hospital managers. This study was conducted on managers of public hospitals at a national level in Iran in 2020. Data were collected using a self-administrated questionnaire. The KPIs were classified into five categories, namely financial, operational, human resources, safety and quality of care, services provided to patients. A total of 234 hospital managers participated in this study. Totally, 25 KPIs were determined for the hospital management dashboard, including the patient falls rate, waiting time for patients in the emergency department, patient satisfaction, total hospital revenue, financial balance, bed occupancy rate, patients' discharge with own agreement, average length of stay, and personnel satisfaction. For designing hospital management dashboards, the domains of services provided to patients, safety and quality of care, financial resources, human resources, and operational are important from the hospital managers' viewpoint, respectively. The results of this study can be helpful for developers of business intelligence tools, such as hospital management dashboards, to visualize the most important indicators for managers.

Assessment of magnitude and associated factors of attitude towards time management among health professionals working in public hospitals of Dessie City, Northeast Ethiopia

BackgroundGood attitude towards to time management is the backbone to bring a change at individual and organizational levels in different sectors across the globe. But it has been ignored by different institutions, particularly in low and middle-income countries including Ethiopia. However, this can be alleviated if there are punctual, committed, and accessible health professionals that could translate the national aspirations and the desire of the community into reality. This study aims to determine the magnitude and associated factors of attitude towards time management among health professionals working in public hospitals of Dessie City, Northeast Ethiopia,MethodsInstitution-based cross-sectional study was conducted from March 24 –April 24, 2021 among 409 health professionals using a stratified sampling technique, Frequency and percentage were used to describe the study population. Multivariable logistic regression analysis was used to identify independent predictors. A p-value of < 0.05 with 95% CI were used to declare statistically significant associations.ResultsThe overall good time management attitude among sample was 67%(95%CI:66.77–67.22%). Satisfaction with organizational policy and strategy (AOR: 2.69, 95%CI: 1.42–5.09), satisfaction with supervisor support (AOR: 2.12, 95% CI: 1.19–3.77), and managers’ good attitude towards time management (AOR: 2.00, 95%CI: 1.23–3.25) were significantly associated with good attitude towards time management among health professionals.ConclusionThe attitude towards time management in public hospitals of Dessie City was low. Satisfaction with organizational policies and strategies, satisfaction with supervisor support, and managers’ good attitude towards time management were delineated factors. This low attitude towards time management could affect the practice and it compromise the health service coverage and quality unless timely and appropriate interventions should be taken. Strengthening strategies aimed at maximizing job satisfaction and emphasizing an attitude towards time might have a substantial contribution.

The burden of critical illness among adults in a Swedish region—a population-based point-prevalence study

BackgroundPatients with critical illness have a high risk of mortality. Key decision-making in the health system affecting the outcomes of critically ill patients requires epidemiological evidence, but the burden of critical illness is largely unknown. This study aimed to estimate the prevalence of critical illness in a Swedish region. Secondary objectives were to estimate the proportion of hospital inpatients who are critically ill and to describe the in-hospital location of critically ill patients.MethodsA prospective, multi-center, population-based, point-prevalence study on specific days in 2017–2018. All adult (> 18 years) in-patients, regardless of admitting specially, in all acute hospitals in Sörmland, and the patients from Sörmland who had been referred to university hospitals, were included. Patients in the operating theatres, with a psychiatric cause of admission, women in active labor and moribund patients, were excluded. All participants were examined by trained data collectors. Critical illness was defined as “a state of ill health with vital organ dysfunction, a high risk of imminent death if care is not provided and a potential for reversibility”. The presence of one or more severely deranged vital signs was used to classify critical illness. The prevalence of critical illness was calculated as the number of critically ill patients divided by the number of adults in the region.ResultsA total of 1269 patients were included in the study. Median age was 74 years and 50% of patients were female. Critical illness was present in 133 patients, resulting in an adult population prevalence of critical illness per 100,000 people of 19.4 (95% CI 16.4–23.0). The proportion of patients in hospital who were critically ill was 10.5% (95% CI 8.8–12.3%). Among the critically ill, 125 [95% CI 94.0% (88.4–97.0%)] were cared for in general wards.ConclusionsThe prevalence of critical illness was higher than previous, indirect estimates. One in ten hospitalized patients were critically ill, the large majority of which were cared for in general wards. This suggests a hidden burden of critical illness of potential public health, health system and hospital management significance.

A Systematic Review of Factors Influencing the Maintenance Management of Public Hospitals in Nigeria

A Systematic Review of Factors Influencing the Maintenance Management of Public Hospitals in Nigeria

Evaluation of clinical ethics in Iranian hospitals: Employing a 360° approach-A cross-sectional study.

Clinical ethics is defined as recognizing and resolving value conflicts that arise from providing care in medical centers. This study aimed to evaluate the practice of clinical ethics in Iranian hospitals with a 360° approach. The study was conducted by employing a descriptive-analytical method in 2019. The statistical population included staff, patients, and managers of public, private, and insurance hospitals in Mazandaran province. The sample size for each group was 317, 729, and 36, respectively. The data collection tool was a researcher-made questionnaire. The appearance and content validity of the questionnaire were confirmed by expert opinion and construct validity was confirmed by confirmatory factor analysis. The reliability was confirmed by Cronbach's alpha coefficient. Data were analyzed by one-way analysis of variance and Tukey's post-hoc test. We used SPSS software version 21 to analyse the data. The obtained mean score of clinical ethics from the perspective of service providers (0.56 ± 4.45) was higher than the perspective of service presenters (4.35 ± 0.65) and service recipients (0.79 ± 4.22), which was statistically significant (p < 0.05). Among the eight dimensions of clinical ethics, respect for the patient's right (0.68 ± 4.09) illustrated the highest score and medical error management (0.63 ± 4.33) presented the lowest score. Based on the findings of the study, the level of clinical ethics in the hospitals of Mazandaran province is favorable, and among the dimensions of clinical ethics, respect for patient rights gained the lowest score and communication with other colleagues gained the highest score. Therefore, informing and teaching medical professionals in the field of clinical ethics, formulating binding laws, and paying serious attention to this issue in ranking and accrediting hospitals are recommended.