Assessing equity in the distribution of hospital beds: evidence from northern Iran

Objective: To assess equity in the distribution of hospital beds in northern Iran. Methods: In this cross-sectional study, we investigated the degree of equity by using 2016 census data from 16 cities in Guilan province. The hospital beds include burns, intensive care unit, coronary care unit and neonatal intensive care unit beds. We analysed the general status and explored its distribution equity by using the Theil index. Findings: We found that Rezvanshahr and Masal had no hospital beds. The utilisation gap was positive only in Rasht, as capital of the province. Neonatal intensive care unit beds were only found in Rasht and Lahijan. Rasht was shown to have a positive gap in using burns, intensive care unit and coronary care unit beds, with a negative gap of 14.68 in coronary care unit beds. The other 15 cities did not have such hospital beds. For intensive care unit, coronary care unit and neonatal intensive care unit beds, nearly 8%, 2% and 14% of cities were deprived of being equipped with these hospital beds, respectively. The highest positive gap and the lowest negative gap were attributed to coronary care unit beds. In the province, there were 0.057 burns beds, 0.137 intensive care unit beds, 0.381 coronary care unit beds and 0.72 neonatal intensive care unit beds per 10,000 population (neonatal intensive care unit beds, per 1000 neonates). In 11 out of 16 cities, the number of coronary care unit beds per 10,000 population was higher than the provincial average. The highest inequality in distribution was shown to be for burns beds (0.8), neonatal intensive care unit beds (0.75), intensive care unit beds (0.55) and coronary care unit beds (0.21), respectively. Conclusion: This study revealed high inequalities in the distribution of hospital beds in northern Iran. The local and national policy-makers should design and implement a comprehensive monitoring and evaluation system for tracking and allocating healthcare resources, both qualitatively and quantitatively, which appears to be very necessary to increase the equity in access to healthcare services.

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Needs Assessment of Family With Neonates Hospitalized in Neonatal Intensive Care Unit

10.21203/rs.3.rs-288283/v1 ◽

2021 ◽

Author(s):

Sedigheh Razzaghi ◽

Yadollah Zahed Pasha ◽

Karimollah hajian-Tilaki ◽

Sousan valizadeh ◽

Afsaneh Arzani

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Correlation Coefficients ◽

Cross Sectional Study ◽

Family Needs ◽

Northern Iran ◽

Term Infants ◽

Cross Sectional

Abstract Background: The neonate’s birth and subsequent hospitalization cause families to experience various needs. Assessing the family needs can lead identify the real needs of parents, provide qualitative services and implement family-centered care by nurses. The aim of this study was to assess the needs of families with neonates hospitalized in neonatal intensive care unit. Materials and Methods: This cross-sectional study was conducted on 360 parents of neonates admitted to NICU in northern Iran in 2018- 2019. Data were collected by demographic questionnaire of parents and neonates and NICU Family Needs Inventory (NFNI) of Ward with 5 dimensions of proximity, assurance, information, comfort and support. Data were analyzed using independent t-test, Pearson and Spearman correlation coefficients. Results: The most important dimensions of family needs, proximity to infant (93.59%), information (90.53%), assurance (89.18%), comfort (86.70%) and support (80.78%).Comparison indicated that the dimensions of need including assurance of multiparous parents (P<0.001) and comfort in parents with term infants (P<0.02) were significantly more than the rest. Conclusion: According to the results of this study, the most important dimension of family needs is proximity to infants. Therefore, it is recommended that the relevant authorities should take effective measures to provide parent-infant proximity.

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Evaluation of Nurses’ Workload in the Intensive Care Unit, Neonatal Intensive Care Unit and Coronary Care Unit: An Analytical Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/44824.14181 ◽

2020 ◽

Author(s):

Maryam Azadi ◽

Jalil Azimian ◽

Maryam Mafi ◽

Farnoosh Rashvand

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Analytical Study ◽

Pearson Correlation ◽

Risk Of Death ◽

Increased Risk ◽

The Mean ◽

Coronary Care

Introduction: The workload on nurses can have adverse effects on the patient, nurse and healthcare system such as reduced quality of care, increased risk of nursing errors, reduced patient satisfaction, increased nurse anxiety, increased nursing job stress, increased risk of infection, increase in the length of hospital stay and increased risk of death. Aim: The present study was designed and conducted to compare nurses’ workload in the Intensive Care Unit (ICU), Neonatal Intensive Care Unit (NICU), and Coronary Care Units (CCU). Materials and Methods: The present study is a cross sectional analytical study that was conducted in the ICU, NICU and CCU of educational hospitals affiliated to Qazvin University of Medical Sciences. The convenience sampling method was used. A nursing activity score was used to assess nurses’ workload. The total score in this instrument is between zero and 178. Data were analysed using SPSS 16. Pearson correlation coefficient, chi-square, independent t-test, one-way analysis of variance was used. Results: The mean score of the total workload in nurses was 104.19±25.18. Regarding the primary purpose of the study, the results of the present study showed that the mean score of nurses’ workload was significantly higher in nurses working in the NICU than nurses working in the ICU and CCU (p<0.05). Among the demographic variables, only the marital status was significantly associated with nurses’ workload, that married nurses experienced more workload in some shifts (p<0.05). Conclusion: Nurses working in NICUs experienced a higher level of workload compared to the nurses in ICU and CCU. Due to the high workload of nurses in the NICU and the complications that this can cause for neonatal patients and nurses, it is necessary to pay more attention to the distribution of nurses in these wards.

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The Psychosocial Aspects of Feeding in the Neonatal Intensive Care Unit and Beyond

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_persp-19-00097 ◽

2019 ◽

Vol 4 (6) ◽

pp. 1507-1515

Author(s):

Lauren L. Madhoun ◽

Robert Dempster

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Hospital Discharge ◽

Neonatal Intensive Care ◽

Oral Feeding ◽

Medical Attention ◽

Primary Role ◽

Speech Language Pathologists ◽

The Family

Purpose Feeding challenges are common for infants in the neonatal intensive care unit (NICU). While sufficient oral feeding is typically a goal during NICU admission, this can be a long and complicated process for both the infant and the family. Many of the stressors related to feeding persist long after hospital discharge, which results in the parents taking the primary role of navigating the infant's course to ensure continued feeding success. This is in addition to dealing with the psychological impact of having a child requiring increased medical attention and the need to continue to fulfill the demands at home. In this clinical focus article, we examine 3 main areas that impact psychosocial stress among parents with infants in the NICU and following discharge: parenting, feeding, and supports. Implications for speech-language pathologists working with these infants and their families are discussed. A case example is also included to describe the treatment course of an infant and her parents in the NICU and after graduation to demonstrate these points further. Conclusion Speech-language pathologists working with infants in the NICU and following hospital discharge must realize the family context and psychosocial considerations that impact feeding progression. Understanding these factors may improve parental engagement to more effectively tailor treatment approaches to meet the needs of the child and family.

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