Introduction: Information documented in the medical records includes demographic Factors, history, examination and treatment. Information documented in the health record file has impressive Effect on the quality of care and treatment of patients. The pieces of information concerning patients who need operation are completed in special operation sheet htat should be exact, on time and complete.
Methods: The present study was carried out by a cross-sectional method during the spring of 2003 to compare the completion of special operation sheets among two medical teaching hospitals (Imam Khomeini and Motahari) affiliated to Uromia University of Medical Sciences. In this study special operation sheets of 200 files in every hospital (total 400 files) were reviewed. The collected data were analyzed by SPSS program and using Chi square and T tests.
Findings: the proportion of items completed on the pre- operation care sheet, anesthesia sheet, operation report sheet and recovery room sheet subsequently %66, %42, %79 and %65 in the hospitals. Overall special operation sheets in Imam Khomeini hospital were more complete than Motahari Hospital (%69 versus %59).
Results: Low proportion of sheet completion in the hospitals studied necessitates the use of electronic record systems, recruiting medical records university graduates, encouraging efficient personnel and having workshops to upgrade the completeness and accuracy of documentations of information in files.
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