Factors Affecting Quality of Emergency Service in Iran's Military Hospitals: A Qualitative Study

INTRODUCTION

Quality is a key factor for the success of any organization. Moreover, accessing quality in the emergency department is highly significant due to the sensitive and complex role of this department in hospitals as well as the healthcare and medical treatment system. This study aimed to identify, from the perspective of medical experts and nurses serving in the military health and medical treatment system, the factors that affect the quality of emergency service provided in selected military hospitals in Iran.

METHODS

This qualitative research was performed in Valiaser Hospital of Tehran (Iran) in 2015, using the framework analysis method. The purposive sampling technique was used for data collection. A total of 14 participants included two emergency medicine specialists, four general physicians, two senior nurses (holding M.Sc. degrees), and six nurses (holding B.Sc. degree). Data were collected through semistructured interviews. Sampling continued until data saturation occurred. The Atlas/Ti software was employed for data analysis.

RESULTS

Four basic themes emerged as the effective factors on the quality of emergency services, namely, structural themes, process/performance themes, outcome themes, and environmental/contextual themes. Moreover, through a framework analysis, 47 subthemes were specified and summarized as indicators of the different aspects of the main themes.

CONCLUSION

The factors affecting the quality of emergency services in Iran's selected military hospitals are especially complicated due to the diversity of the missions involved; thus, different factors can influence this quality. Therefore, an effort should be made to tackle the existing obstacles, facilitate the identification of these effective factors, and promotion of the quality of healthcare services.

Sensitivity pattern of methicillin resistant Staphylococcus aureus isolated from patients admitted in a tertiary care hospital of Pakistan

BACKGROUND AND OBJECTIVES

Methicillin resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen causing significant morbidity and mortality. The aim of this study was to evaluate in vitro activities of different antibiotics against methicillin resistant Staphylococcus aureus.

MATERIALS AND METHOD

The study was conducted over a period of one year (January 2009 - December 2009) in the Department of Microbiology, Army Medical College, the National University of Sciences and Technology, Pakistan. One hundred and thirty-nine Methicillin resistant Staphylococcus aureus isolated from the clinical specimens at Rawalpindi Military Hospital were subjected to in vitro susceptibility against various antimicrobials using Kirby Bauer disc diffusion technique.

RESULTS

All the isolated MRSA organisms were uniformly susceptible to vancomycin, linezolid and tigecycline. Other drugs which were found to be effective were chloramphenicol, and rifampacin. Most of the MRSA were isolated from pus samples.

CONCLUSION

Vancomycin, tigecycline and linezolid were effective against methicillin resistant strains of S.aureus. This study suggests that chloramphenicol and rifampacin also have good in vitro efficacy for methicillin resistant S. aureus infections. Oral dosing option for linezolid, chloramphenicol and rifampacin can allow earlier discharge of hospitalized patients and thus reduce health care expenses as well as help reduce the chances of vancomycin resistant strains emergence.