Background and Objectives: Insertion of an intraosseous access device enables intravascular access for critically ill patients in a prehospital and emergency department setting even when intravenous ...access is not possible. The aim of our study was to assess the attitudes of prehospital and emergency department nursing staff towards the utilization of intraosseous access devices. Materials and Methods: We performed quantitative research using a closed-ended structured questionnaire distributed to prehospital unit and associated emergency department nursing staff serving a population of around 200,000 inhabitants. Results: We distributed 140 questionnaires, and 106 were returned and completed. Of these, 69 (65.1%) respondents needed more than three attempts to achieve peripheral intravenous access at least once in the last year and 29 (27.4%) required central venous access because of impossible intravenous access. In the last five years, 8 (7.5%) respondents used endotracheal route for administration of medications. Despite this, only 48 (45.3%) of respondents have ever used the intraosseous route. Also, 79 (74.5%) respondents received at least some training in obtaining IO access; however, 46 (43.4%) answered that education regarding intraosseous access is not sufficient, and 92 (86.8%) answered that they wanted additional training regarding intraosseous access. Conclusions: Prehospital and emergency department nursing staff are aware of the importance of intraosseous access and understand the need for additional education and certification in this field.
Uvod: Starizem izhaja iz predsodkov in stereotipov o lastnostih, ki jih na podlagi kronološke starosti pripisujemo starostnikom. Namen raziskave je bil ugotoviti, ali starostniki v kliničnem okolju ...doživljajo starizem in v kolikšni meri jih le-ta prizadene. Metode: Opisna kvantitativna raziskava je bila izvedena v zdravstveni ustanovi na priložnostnem vzorcu 132 starostnikov, starih od 65 do 90 let. Uporabljen je bil na podlagi pregleda literature zasnovan vprašalnik z 11 vprašanji zaprtega tipa. Prisotnost starizma in stopnja prizadetosti je bila merjena s tristopenjsko številsko lestvico. Za opis vzorca in sistematičen prikaz odgovorov na raziskovalna vprašanja je bila uporabljena deskriptivna univariatna in bivariatna (hi-kvadrat test za neodvisne vzorce) analiza. Rezultati: Skupno je bilo zaznanih 319 diskriminatornih dogodkov. Od 132 anketiranih je najmanj en diskriminatorni dogodek doživelo 91 (69,0 %) starostnikov. Med slednjimi se je 40 (44,0 %) starostnikov počutilo vsaj enkrat prizadeto in 23 (25,2 %) vsaj enkrat zelo prizadeto. Pri zaznavanju prizadetosti statistično pomembne razlike med skupinami glede na spol (χ2 = 13,554, p = 0,825), izobrazbo (χ2 = 20,807, p = 0,409) in starost (χ2 =19,328, p = 0,501) nismo ugotovili. Diskusija in zaključek: Raziskava potrdi prisotnost starizma v kliničnem okolju. Ker ima starizem negativen vpliv na odnos do starostnika in kakovost njegove oskrbe, je profesionalno komunikacijo s starostniki treba uvesti v izobraževanje vseh profilov zdravstvenih delavcev.
Dehydration in older adults is an important clinical problem associated with more comorbidities, longer hospital stays, and higher mortality rates. However, in daily clinical practice, no single gold ...standard marker of hydration status in older adults is available. The aim of the current study was to define the fluid balance status in older adults residing in institutional care or the home. Four hundred ten patients (192 from institutional care and 218 from home care) 65 and older from the region of lower Styria (Slovenia) were included in the study. Serum osmolality, electrolytes, and blood urea nitrogen to creatinine (BUN:Cr) ratio were used to identify dehydration. Statistically significant differences were found between groups in serum osmolality and BUN:Cr ratio. Moreover, dehydration (defined as increased serum osmolality) was significantly more common in patients in institutional care than home care (51% versus 41.3%, respectively). The results confirm that dehydration is a common clinical problem in older adults, especially in those from institutional care. Although many methods of determining hydration status in older adults have been proposed, no gold standard exists, making hydration evaluation difficult in this population. Res Gerontol Nurs. 2017; 10(6):260-266..
Uvod: Skrb za zadostno hidracijo starostnikov je pogosto izražena, vendar v praksi velikokrat pozabljena. Z raziskavo smo želeli ugotoviti stanje hidracije pri starostnikih, starejših od 65 let, ki ...živijo v socialnovarstvenih institucijah v Mariboru in okolici.
Metode: V retrospektivni raziskavi smo ugotavljali vrednosti označevalcev dehidracije pri 107 starostnikih, starejših od 65 let. Med njimi je bilo 70 (65 %) žensk, povprečne starosti 84,1 let, in 37 (35 %) moških, povprečne starosti 80,4 let. Vzorec je zajemal starostnike, napotene v ambulanto za Internistično nujno pomoč Univerzitetnega kliničnega centra Maribor v obdobju od 1. 11. 2013 do 24. 1. 2014. Analizirali smo laboratorijske rezultate, zbrane v medicinsko-informacijskem sistemu. Kriterije dehidracije so predstavljali: natrij v serumu nad 145 mmol/L, sečnina nad 20 mg/ml oz. razmerje sečnina/kreatinin nad 20 : 1.
Rezultati: Raziskava je potrdila prisotnost povišanih vrednosti označevalcev dehidracije pri 73,8 % obravnavanih starostnikov. En kriterij dehidracije je dosegalo 35 starostnikov, dva kriterija 39 in tri kriterije 5 starostnikov.
Diskusija in zaključek: Ugotovili smo, da povišane vrednosti označevalcev dehidracije ne dajo zanesljivega odgovora o stanju hidracije starostnikov, saj se le-ta lahko glede na uporabljene kriterije preceni ali podceni. Za boljšo oceno hidracije je v nadaljnjih raziskavah potrebno uporabiti natančnejše označevalce v kombinaciji s starostnikovimi kliničnimi znaki in anamnestičnimi podatki.
In some patients securing the peripheral intravenous cannula (PIVC) with a standard adhesive dressing can be difficult because of sweat or other body fluids. The aim of our study was to evaluate the ...use of tissue adhesives alone as a means to secure PIVCs inserted in the emergency department.
We performed a prospective interventional pilot study from November 2019 to May 2020 in a medical emergency department of an urban tertiary hospital. Patients were randomized to two groups: tissue adhesives (TA) or adhesive dressing (AD) group. After randomization we followed them until day 4.
There were no significant differences between TA and AD groups in the rate of unplanned removal of PIVCs in the first 72 h (57.1% vs. 45.8%, p = 0.29), the rate of unplanned removal of PIVCs in the ED (0% vs. 2.1%, p = 1.00), the rate of unplanned removal of PIVC in the first 24 h (42.8% vs. 35.4%, p = 0.52), as well as in the rate of phlebitis (7.1% vs. 14.6%, p = 0.34) and the rate of any blood-stream infection (0% vs. 0%, p = 1.00).
We did not observe any significant differences when PIVCs inserted in the emergency department were secured with tissue adhesives alone, compared to standard adhesive dressings. We observed a high rate of unplanned removal of PIVCs, necessitating further research to determine more reliable ways of securing PIVCs.
Introduction: Ageism is discrimination and prejudice against the elderly based on stereotypes related to their chronological age. The purpose of the study was to establish whether the elderly can ...feel ageism in a clinical setting and how it affects them. Methods: A descriptive quantitative study was conducted in a healthcare institution on a convenience sample of 132 elderly aged 65 to 90 years. A questionnaire based on the literature review with 11 closed-type questions was used. The presence of ageism and the degree of affectedness was measured with a three-digit number scale. A descriptive univariate and bivariate (hi-square test for independent samples) analysis was used for the description of the sample and a systematic representation of the answers to the research questions. Results: In total, 319 discriminatory events were detected. From 132 respondents, at least one discriminatory event was experienced by 91 (69.0 %) elderly people. Of these, 40 (44.0 %) elderly persons felt ageism at least once and 23 (25.2 %) were severely affected at least once. There was no statistically significant difference in affectedness between groups regarding gender (...2 = 13.554, p = 0.825), education (...2 = 20.807, p = 0.409) and age (...2 = 19.328, p = 0.501). Discussion and conclusion: The study has demonstrated a significant presence of ageism in a clinical setting. Since ageism has a negative impact on the relationship towards the elderly and the quality of care, it is necessary to implement basic methods of communication with the elderly in education programs of all healthcare professionals.
The subjective assessment of satisfaction with the quality of life of the elderly varies greatly depending on the living conditions and expectations of the individual. The purpose of our paper is to ...present findings on satisfaction with the quality of life and treatment of elderly people in institutional care and present the results of a study involving 206 elderly people. We have found that there is a statistically significant link between satisfaction with the quality of life and satisfaction with the quality of care provided by employees in old people's homes. The majority, 63,6% of the surveyed elderly, are satisfied with the quality of life. An insight into the quality of life of an aging population is the basis for creating programs for healthy and dignified aging.
The importance of adequate hydration cannot be stressed enough, but it is still a major problem for older people in hospital settings. The aim of study was to establish hydration status of the ...elderly (older than 65 years) living in long term care facilities in Maribor and its surroundings. In a retrospective study the values of markers of dehydration in 107 elderly aged over 65 years were assessed (70 women, average age 84.1 years and 37 men, average age 80.4 years). The elderly were referred to the Internal medicine emergency unit at the University medical centre Maribor in the period between November 1, 2013 to January 24, 2014. The data collected from medical info system were analysed. The criteria for dehydration included Serum sodium > 145 mmol/l, urea > 20 mg/ml or ratio urea/creatinine > 20 : 1. An increased level of markers of dehydration was diagnosed in 73.8 % of the elderly included in the study, 35 participants meeting one criterion of dehydration, 39 participants two criteria and the remaining five meeting all three criteria. Results of the study show that the increased levels of markers of dehydration were not sufficient for accurate hydration assessment of the elderly. The diagnostic criteria used could easily either overestimate or underestimate the true hydration status. In the future research, more precise markers together with accurate evaluation of medical history and clinical signs are necessary to make an accurate assessment of the degree of dehydration in the elderly.
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