Background and Objective: ­ With the development of human societies,­ the needs for different types of health services are increasing. Because of limitations and shortage of national resources, the awareness of health administrators about appropriate allocation of resources leads to efficient use of assets. The aim of this study was to measure the workload and efficacy of nursing staff in internal ward.

  Material and Methods: ­ This descriptive and cross sectional study was conducted on, via census sampling, all nursing activities performed by 10 nurses for 94 patients in Panje-Azar Hospital of Gorgan. ­To determine the efficacy, we asked the subjects to fill out a researcher made, validated questionnaire and measured the time of their presence in the ward. Data analysis was performed by analysis variance, using SPSS-16 software.

  Results: Of ­­total time of presence,­ ­20.3% is spent for documentary activities whereas only 0.49% for patient education. Overall, the spent time for direct and indirect nursing activities is 46.46% and 53.54%, respectively. The efficacy of nursing staff is 62%, ­the highest (66.6­ %) for morning shift and the lowest for night shift (58.34­ %). There is no significant difference, using analysis variance, in efficacy rates of work shifts­ (morning, evening and night).

  Conclusion : In spit of efficacy of over 50 percent in different shifts, the educational programs related to time management, human resource development and electronic nursing are necessary to increase the efficacy.

  Background and Objective: Injection of subcutaneous low molecular weight heparin often causes some local reactions such as ­bruising, hematoma­, and pain, directly related to inappropriate injection method­. This study aimed at determining the effect of injection duration of­ Subcutaneous Enoxaparin Sodium on the size of bruising and the severity of injection pain.

  Material and Methods: This experimental study was conducted on 36 patients medicated by subcutaneous Enoxaparin Sodium (60mg). ­­They were randomly divided into two groups.­ The first group received routine method of subcutaneous anoxaparine injection (10 second duration injection technique) and in the second group in addition to routine method, ­“10 second waits” before removing needle was performed. Data collection was carried out by using a researcher-made check-list consisting of a section for demographic data and a section to record the extent o f bruising and pain intensity.­ The Extent of bruising was measured by using a clear flexible ruler within 24, ­ 48 and 72 hours and pain intensity by visual analog scale (VAS) ,immediately after injection­.­­We analyzed the Data by independent T test and Chi square.

  Results: ­ The ­Results indicate ­­that­ the mean ­of pain intensity in second group (­3.05 ± 1.71­)­ is less than first group (­3.86 ± 2.75­)­.­There is no significant difference between two groups for the extent of bruising in 24, ­ 48 and 72 hours (P>0.05).

  Conclusion: with regard to ­pain intensity and the size­ of the bruising, the two groups are not significantly different.