Investigating the level of innovation and its related factors in nurses working in special departments of medical training centers in Rasht city in 2012

Dissertation

In order to receive a master's degree in intensive care nursing

Introduction: Hospitals need creative and innovative nurses in order to improve the quantity and quality of care, increase competition and efficiency, and reduce costs. The need to have such nurses in special departments that provide complex and unique care to critically ill patients is more felt. The present study was conducted with the aim of determining the level of innovation in nurses of special departments and the individual and organizational factors related to it. Materials and methods: The present study is of a descriptive-analytical type, and the research community was formed by all nurses working in the special care departments of medical educational centers in Rasht in 2013. The sample selection method is the KAI inventory (Kirton Adaptation - Innovation Inventory) along with questions related to the individual and organizational characteristics. The data was analyzed using SPSS software. Results: The average score of nurses was 15/120. 24.95% of nurses are innovative. Also, among the individual factors, the level of innovation with variables such as gender, level of education, and age, and among the organizational factors with variables such as management experience, having a training course in the field of creativity and innovation, and the type of special department had a statistically significant relationship. Facilitate the presentation and implementation of innovative and creative ideas of nurses to provide the basis for solving some of the problems of health care systems. Keywords: innovation, nurses, special departments. And managing changes is the main element of the success and survival of any organization, and the requirement to acquire these abilities is the organization's attention to the innovation and creativity of people. The developments and transformations of today's global society have forced organizations to turn to creativity and innovation in order to live in such a changing and unstable environment and direct their goals, tendencies and interests in the direction of applying creativity and innovation. The unpredictability of future trends and developments, which is the most important feature of the current information age, has increased the need to pay attention to creativity and innovation in organizations [1]. Innovation is the implementation of a new idea in doing things with the aim of improving the quality of the product or service provided to the customer [2]. Individual factors include factors related to people's temperament, such as (self-confidence, acceptance of ambiguity, patience, generalism, great curiosity, and acceptance of complexity) [3], motivational factors, and factors related to people's knowledge and expertise.   Organizational factors affecting innovation include factors related to organizational structure, factors related to organizational culture, factors related to the educational system, factors related to the reward system, and factors related to facilities, which can be brought to the border of creativity by providing a suitable platform for cultivating and expanding creativity and innovation in the people of an organization [1]. The result of a study in a manufacturing company in 2005 in America showed that by providing the opportunity for innovation among employees and modifying the company's structure to strengthen innovation, the company's revenue increased by 71%, customer satisfaction by 76% and productivity by 71% [4]. Today, there is a general consensus that successful organizations are those whose innovation is the spearhead of their movement. In other words, today's organizations must be dynamic in order to survive, and their managers and employees must be innovative so that they can adapt the organization to these changes and respond to the needs of the society [1].

The importance of paying attention to innovation in the success of organizations is not only limited to the production sectors, but also in the service and academic sectors, considering the type of customers (patients), this concept is very important [5]. In order to provide quality and effective care, healthcare systems need to develop and strengthen innovation in hospitals so that they can effectively identify the needs of patients and choose the best problem solving method based on these needs and use human and non-human resources and the organization's facilities in the best possible way [6]. The challenges in providing quality care with the increasing age of people in human society, the increase in the prevalence of chronic diseases, the expansion of information technology and the increase of patients' awareness of their rights increase the need for innovation in care. Therefore, without innovation, hospitals will be forced to put pressure on the staff to reduce costs and maintain them and satisfy the clients[7]. Especially in environments where multiple and long-term care is provided, increasing the need for high-quality care despite limited resources creates certain problems in reaching a desired goal [8]. It is in this situation that only innovation can establish a bridge between quality care and effective, efficient and high-quality clinical work [6] and [8] and [9]. Considering that about 80% of the care provided to patients in hospitals is done by nurses and considering that about 70% of the hospital staff are nurses, the importance of paying attention to the issue of innovation in this group doubles [10]. In this regard, in 2009, the International Association of Nurses included innovation among the professional skills required by nurses[11]. The result of a study in 2002 in America, which was conducted with the aim of investigating the importance of innovation in nursing, shows that the existence of innovation is necessary for the future of nursing and nurses must be innovative to facilitate the provision of better services and quality care [12]. The concept of innovation in nursing means turning ideas into new methods and solutions in patient care, which ultimately leads to improving the quality of care[13]. Therefore, among the puzzle of clinical skills, problem-solving skills and innovation in care that become routine over time; be merged [14]. Innovation in nurses increases the safety of patients, more effective and faster therapy, and also causes efficiency, effectiveness, timely delivery of care to the patient [15] and finally increases the quality of care and improves the nursing process and improves the outcome of hospitalization [16]. Regarding the impact of innovation in the process of treating patients and its benefits in increasing patient safety and reducing treatment and diagnostic costs, the result of a study in a hospital in Chicago in 2003 showed that only changing a treatment protocol (sedation and hypnosis) and using a new treatment protocol before performing a CT scan[1] and MRA[2] to what extent increases patient safety, reduces complications, increases the satisfaction of patients and their families, accelerates the diagnostic and treatment process, and saves about 600 dollars in costs. became In this study, the nurses' association of this hospital came to the conclusion that often due to the inadequacy of sleeping and sedative drugs used before CT scan and MRI in hospitalized children, these diagnostic procedures were not performed at the appointed time due to restlessness of the children or were repeated several times due to the lack of clarity in the stereotypes, and children were exposed to multiple doses of radiation due to the repetition of CT scans and the panic caused by repeated MRIs. The nurses' association of this hospital suggested that intranasal midazolam protocol should be used instead of existing methods to calm and put the patient to sleep before CT scan and MRI. The trial use of this new protocol was very successful and satisfactory, and the new method replaced the previous methods in order to increase the patient's safety and reduce the cost [17]. Regarding the usefulness of innovation for patients from the perspective of innovation in information technology and the exchange of medical and nursing information in order to improve diagnostic, therapeutic and care interventions, numerous studies show that with innovation in information technology, nurses and doctors can share the results of their clinical findings in diagnosis and treatment and how to care with their colleagues around the world and challenge each other, and patients will also be able to easily access their medical information all over the world and in all medical centers [5] and [7].

But innovation is more necessary in centers where more complex care is provided to clients, such as special departments [14] and [18] and [6].