Aim
To examine Croatian nurses’ perception of implicit nursing care rationing and the patient safety culture from the perspective of acute care hospital staff.
Background
In the past three decades, ...the Croatian health system has undergone numerous transformations driven by geopolitical, legal, financial, demographic, scientific and technological progress. These changes have led to systemic changes in the structure, organisation, financing and delivery of health care, and thus, of nursing care.
Methods
A cross‐sectional study of 438 nurses was conducted at four university hospitals in Croatia, based on the Perceived Implicit Rationing of Nursing Care Questionnaire.
Results
A lower assessment of the quality of care in the unit is associated with a higher score on the Perceived Implicit Rationing of Nursing Care Questionnaire, r = –.379, p < .001. A lower satisfaction with the current workplace is associated with a higher score on the Perceived Implicit Rationing of Nursing Care Questionnaire, r = −.432, p < .001.
Conclusion
The perception of nurses in Croatia indicates that the implications of nursing care rationing and dissatisfaction with their post in acute care hospital units are closely related to poor quality of nursing care provided to patients.
Implications for Nursing Management
Based on these results, nurse managers should take their nurses’ perceptions of implicit nursing care rationing into consideration in order to develop strategies to improve nursing care delivery, nursing satisfaction and, consequently, better nursing care quality.
Croatian National Cancer Patient Experience Survey Karabatić, Sandra; Šajnić, Andreja; Pleština, Sanja ...
International journal of environmental research and public health,
07/2022, Letnik:
19, Številka:
14
Journal Article
Recenzirano
Odprti dostop
Background: Cancer patients’ experiences of the healthcare system, care, and treatment are increasingly viewed as important in order to inform and improve quality of care, patient safety, and ...treatment efficacy. Understanding patient experience is a key step in moving toward patient-centred care. The aims of this study were to determine the experience of cancer patients in Central and Eastern European countries and to identify the needs and perspectives of oncological patients during the cancer treatment. In this paper, results from Croatia are presented. Methods: A sixty-nine item online survey was translated by native-language participating countries. Only registered members (subjects with confirmed cancer diagnosis) of the national patient oncology associations in each participating country were allowed to access and complete the online questionnaire (n = 16,458). Data were collected between October 2018 to February 2019. The Croatian Coalition of Health Associations enabled the authors of this paper to use the collected data from a sample of the Croatian participants (n = 2460) for the purposes of publication. Results: Two-thirds (67.3%) of the respondents reported satisfaction with the length of time needed for getting tests done. Bad news was delivered sensitively to 52.97% of the participants, and 52.76% received a cancer treatment plan. During the hospitalisation, 45.93% responded that they did not find someone from the hospital staff whom they could talk to about their worries and fears, and 57.48% were not given any contact information in case of concerns about their condition or treatment following the discharge. Regarding the patients’ preferences, needs, and values, 60.81% of the respondents felt that the greatest improvement would be to perform all services in one place, and 55.28% felt that improvement would be achieved through a multidisciplinary team coordinated by one person. Conclusions: The study reveals domains that need to be addressed in the overall Croatian healthcare system for oncology patients. Based on the obtained data, we can conclude that there is a large need for improvement in patient experience on the oncology pathway.
Although nurses in intensive care units (ICUs) are exposed to prolonged stress, no burnout prevention policy has yet been established. This study aims to determine the attitudes and "sense" of ...knowledge of burnout in nurses with burnout.
The study, which has a qualitative exploratory phenomenological design, was carried out in several Croatian ICUs in 2017. ICU nurses suffering from burnout according to their score on the Maslach Burnout Inventory were chosen randomly from five hospitals. Their participation was voluntary. Of the 28 participants, 86% were women (n=24) and 14% men (n=4). They were aged mainly between 36 and 45 (n=11 (40%)) and between 26 and 35 (n=10 (36%)). Semi-structured interviews were conducted up to the saturation point. The conversations were audio-recorded and transcribed verbatim. The text was analysed using inductive thematic analysis, with codes derived and grouped into clusters by similarities in meaning, and interpretation as the final stage.
Emergent themes, compromised private life, stressful work demands, stress reduction options, protective workplace measures and sense of knowledge reflected a variety of experiences, attitudes and knowledge of burnout.
Nurses with burnout provided an insight into their experience and attitudes, and the problems created by burnout. Given the poor sense of knowledge about this syndrome, there is a need to implement education on burnout in nursing school curricula, and clear strategies in the ICU environment, i.e. information, awareness-raising, and specific guidelines on coping, burnout detection and prevention. Approaching burnout prevention through attitudes/social learning may be a novel and feasible model of addressing this issue.
To compare the effect of intermittent tramadol dosing vs tramadol administration via patient-controlled pump on pain after lumbar discectomy.
This randomized prospective study enrolled 100 patients ...who underwent elective LIV-LV lumbar discectomy in the neurosurgery department at Sestre Milosrdnice University Hospital Center from May 2016 to July 2017. Patients were randomized to receive either tramadol (600 mg daily) via a patient-controlled analgesia (PCA) pump or intermittently. Pain was evaluated by the Croatian version of Short-Form McGill Pain Questionnaire.
Forty percent of patients were women. The median (interquartile range) age of the patients was 51 (40-61) years. The groups did not differ in pain at 7 pm on the day of discectomy. However, in the morning and evening on the first postoperative day and in the morning and evening of the second postoperative day, the PCA group had significantly lower pain (P=0.023, P<0.001, P<0.001, P=0.026, respectively).
This is the first study that used the Short Form McGill Pain Questionnaire to compare the effect of tramadol administration via PCA pump and intermittent administration on pain after LIV-LV discectomy in a neurosurgery department. Tramadol showed a good analgesic efficacy in lumbar spine surgery; tramadol via PCA controlled pain more effectively than intermittently administered tramadol.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Sepsis is defined as life-threatening organ dysfunction caused by an unregulated host response to infection. The emphasis is on the imbalance of homeostasis and the response to infection, as well as ...mortality and the importance of recognizing sepsis as early as possible. The knowledge of undergraduate nursing students is an extremely important indicator for future work in the healthcare system after graduation. The aim of this study was to investigate the levels of knowledge about sepsis among undergraduate nursing students and to compare differences in different years of study, as well as differences in their study model.
A cross-sectional study was conducted on 618 nursing students at the University of Applied Health Sciences in Zagreb, Croatia. All three years of study and both full-time and part-time (employed) nursing students were included. The questionnaire "Determinants of Sepsis Knowledge" was used in the research.
The percentage and number of third-year students who correctly answered the items on Knowledge of Sepsis were statistically significant compared to the first two years of study. The percentage and number of employed students who responded correctly to the items on Knowledge of Sepsis were statistically significant compared to students who were not employed.
The ability of nursing students to recognize and respond to the deterioration in a patient's condition due to sepsis is very important, so appropriate education about sepsis is essential. We recommend a greater representation of sepsis content in the core curriculum of nursing students' education in terms of theoretical instruction and clinical and simulation exercises.
Approximately 8000 people suffer from an out-of-hospital cardiac arrest (OHCA) in the Republic of Croatia every year. OHCA survival rates generally remain low despite major advances in resuscitation. ...Its incidence and survival rate are well known in many European countries, but reliable data on OHCA in Croatia are lacking. The aim of the study was to determine survival rate of patients with OHCA in the Republic of Croatia and the importance of the community bystander cardiopulmonary resuscitation (CPR) rates in the survival chain. This prospective observational study performed between October 1, 2017 and December 31, 2017 included all adult patients with OHCA in Croatia who were treated by Emergency Medical Services (EMS). OHCA data were collected from the Croatian Institute of Emergency Medicine database and Utstein cardiac arrest data collection form. Descriptive data presentation was used in the analyses. Data were expressed as absolute frequencies and percentages and central tendency measures. Testing of correlations in return of spontaneous circulation (ROSC) was performed by logistic regression. During the observation period, a total of 1763 adult patients without signs of circulation were assessed by EMS in Croatia and 760 (43%) adult patients were resuscitated by EMS personnel. Outcomes measured in ROSC until emergency department admission were reported in 126 (17%) cases. Shockable rhythm
. non-shockable rhythm (OR: 5.832, 95% CI: 3.621-9.392; p<0.001) and bystander witnessed cardiac arrest (OR: 8.213, 95% CI: 2.554-26.411, p<0.001) were significantly associated with a higher probability of survival. There was no significant difference in correlation with day or night shift, etiology of cardiac arrest and bystander CPR variables. Survival rate of OHCA patients who received CPR until emergency department admission in Croatia was 17%. A higher survival rate post-OHCA was more likely among patients who received bystander CPR and had shockable rhythm.
Continuous Professional Development (CPD) is essential for nurses to maintain up-to-date knowledge and skills in the evolving healthcare sector. This study explores nurses' attitudes toward CPD, its ...necessity, and the challenges encountered. The aim is to examine nurses' perspectives on CPD, focusing on their participation and motivation, in relation to their workplace, workplace function, and form of work. A cross-sectional study design was employed with 151 nurses from University Hospital Centre Split, Croatia. Data were collected using the "Professional Development of Nurses questionnaire (Q-PDN)" and analyzed using descriptive statistical methods, the Kolmogorov-Smirnov test, Pearson's correlation, ANOVA test, and
-test. The average level of participation in CPD activities was 4.27 (±0.63), indicating a positive inclination towards CPD. The study identified a statistically significant difference in activities related to CPD (t = 2.12;
= 0.036) among employees of surgical and intensive care units compared to other departments, where a higher level of engagement was present among employees of other departments. Notably, nurses without managerial roles showed 0.16 points higher participation in CPD activities compared to their managerial counterparts, though this was not statistically significant (t = 0.92;
= 0.357). Nurses in managerial roles valued CPD for professional development more highly, with a significant difference (t = 2.77;
= 0.006). Full-time nurses demonstrated a higher perception of the importance of personal professional development compared to part-time nurses, with a significant difference (F = 2.88;
= 0.038). The study reveals a strong commitment to CPD among nurses, with variations based on workplace roles and schedules. It underscores the need for role-specific and adaptable CPD programs to meet diverse needs and enhance professional competence in the nursing workforce.
The aim was to perform adaptation and validation of the Perceived Implicit Rationing of Nursing Care. Implicit delaying of nursing care is an intermediate step, linking nurses with the quality of ...outcomes for patients and nurses, and it is the result of prioritization of health care measures within the assigned group of patients cared for by nurses. The Perceived Implicit Rationing of Nursing Care instrument is a tool used to assess the rationing of care in nursing practice. Study participants were nurses working at hospital wards in 4 university hospitals in the Republic of Croatia. The questionnaire was filled-in by 438 nurses. Data were collected between April and November 2018. After principal axis factoring, a single factor solution based on the correlation matrix was adopted. The measured construct is one-dimensional, and the extracted factor explains 47.2% of its variance. Additionally, the reliability of the whole questionnaire was determined by using the internal consistency coefficient Cronbach alpha on the Perceived Implicit Rationing of Nursing Care with 31 of 0.96 particles, which is extremely high internal consistency reliability. In conclusion, the study found a high level of reliability and validity of the translated Perceived Implicit Rationing of Nursing Care questionnaire, fully comparable to that of the original. The questionnaire can be used to assess the phenomenon of implicit care rationing in Croatian hospitals.
Introduction: Burnout syndrome is a growing concern among nursing students, potentially impacting their academic success and future professional performance. This study aimed to explore the ...prevalence of burnout syndrome in Croatian nursing students and examine the associations between burnout and demographic features (age, gender, year of study, part-time or full-time study).
Methods: A quantitative cross-sectional study was conducted with 423 nursing students from the University of Applied Health Sciences, Zagreb, and the Faculty of Health Sciences, Rijeka. The Maslach Burnout Inventory (MBI); MBI human services survey was used to assess burnout levels.
Results: Nursing students at the Faculty of Health Sciences, Rijeka, experienced higher burnout levels than those at the University of Applied Health Sciences, Zagreb (χ2 = 10.214, ss = 2, p = 0.006). Significant associations were found between burnout levels and age, gender, year of study, and enrolment status. Specifically, younger students, female students, and full-time students reported higher levels of emotional exhaustion (EE). 2nd-year students reported lower EE than their first and 3rd-year peers.
Conclusions: This study underscores the importance of recognizing and addressing the unique needs and stressors faced by different subgroups of nursing students. Tailored interventions and support systems are essential for alleviating burnout and promoting well-being in nursing students. Further research, including longitudinal studies, is required to better understand burnout progression and to inform the development of effective strategies for reducing burnout in nursing education.
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