Abstract

Aim. This study aimed to examine the effect of application of Braden pressure ulcers risk assessment tool on performance of critical care nurses.

Background. Pressure ulcer is a common phenomenon in patients admitted to intensive care unit. The management of pressure ulcers in these patients is a challenging task. Therefore, pressure ulcer prediction tools are used when dealing with these patients.

Method. This quasi-experimental study was conducted in the intensive care units. The study sample consisted 68 critical care nurses working inintensive care units of selected hospitals of Tehran University of Medical Sciences in 2013. After determining the sample size and obtaining permission from theethics committee of Tehran University of Medical Sciences, the participants were recruited through convenience sampling based on inclusion criteria. Critical care nurses of two intensive care units of general hospitals of Tehran University of Medical Sciences were selected as experimental and control group. In both groups, after collecting demographic characteristics, their performance in the management of patients who were at risk for pressure ulcers was evaluated by the checklist whose validity and reliability was evaluated by the faculty members of Tehran University of Medical Sciences. The data were analyzed by descriptive and inferential statistics in SPSS version 19.

Findings. There was no statistically significant difference between the groups in terms of demographic characteristics. After the intervention, the mean score of nurses performance in the experimental group was 66.21±0.47 and that of control group was 62.59±1.31 (p≤0.0001). After intervention, all nurses in the experimental group had very good performance and nurses in the control group had good performance.

Conclusion. Using the pressure ulcers risk assessment tool (Braden scale) increases the sensitivity of critical care nurses to the risk of ulceration in the intensive care unit patients and forces them to comply with the standard caring measures and consequently, lead to prevention of bed sores. It is recommended to use this tool in order to enhance the care management of patients prone to pressure sore.

Abstract
Aim. The purpose of this study was to investigate the key performance indicators in the emergency department.
Background. Health care organizations are confronted with various phenomena such as the rapid promotion of technology, changing demographic factors and changing lifestyles. On the other hand, the health care system has become one of the largest and most expensive industries in the world. These factors have led hospital management to require fundamental changes, including for organizations to measure performance to achieve organizational goals. Evaluation and monitoring of emergency department performance is one of the most important processes in health centers.
Methods. In this review study, the articles were searched out using the keywords “key performance indicators” and “emergency department” and their Persian equivalent in Jahad Daneshgahi Database, Iran Scientific Research Institute, Database of Iranian Journals, Springer, Medline, PubMed, and Google Scholar. Forty eight articles were found. These articles were reviewed and refined step by step and finally, 16 related articles were selected. Then, selected sources were included in the data collection form according to the purpose of the study and narrative analysis was performed.
Findings. Based on the results of this study, the articles have addressed three aspects of the importance of performance appraisal in the emergency department, key performance indicators and their types (input indicators, process indicators, outcome indicators) that are explained in detail.
Conclusion. Managers and decision makers are always faced with the problem of choosing the best index from a diverse set of indicators, and often because of data aggregation, not all of them can be used. For this reason, managers and employees have a negative view of performance evaluation systems, and it is necessary to identify a limited number of key indicators that can meet an organization's management goals.