Uvod: Zdravstvena nega je znanstvena disciplina, zato morajo diplomirane medicinske sestre v prihodnosti z raziskovalnim delom slediti znanstvenoraziskovalnemu razvoju. Namen raziskave je bil ...ugotoviti odnos diplomiranih medicinskih sester do raziskovanja, s katerimi ovirami se srečujejo pri tem in v kolikšni meri se odločajo za raziskovalno delo.Metode: Uporabljena je bila kvantitativna neeksperimentalna metoda raziskovanja. Raziskava je bila izvedena s pomočjo strukturiranega vprašalnika med 110 diplomiranimi medicinskimi sestrami v zdravstveni dejavnosti na primarni in terciarni ravni. Zanesljivost vprašalnika je bila preverjena s koeficientom Cronbach alfa (Cronbach α = 0,72). Raziskava je bila izvedena v maju in juniju 2018. Uporabljeni sta bili opisna statistika in bivariatna analiza z Mann-Whitneyevim in Kruskal Wallisovim testom.Rezultati: Diplomirane medicinske sestre se v večini strinjajo (x = 4,23, s = 0,895), kako pomembno je, da zdravstvena nega temelji na dokazih. Oviro pri raziskovanju jim predstavljata znanje (x = 3,39, s =1,000) in pomanjkanje časa (x = 3,76, s = 0,877). Diplomirane medicinske sestre v zdravstveni dejavnosti na terciarni ravni so raziskovanju bolj naklonjene (x = 4,16) kot tiste na primarni ravni (x = 3,79, U = 1102,00, p = 0,008).Diskusija in zaključek: Diplomirane medicinske sestre se strinjajo, da je z dokazi podprta praksa v zdravstveni negi nujna. V raziskovanje se ne vključujejo zaradi pomanjkanja znanja, časa in pomanjkanja podpore sodelavcev. Za dvig ravni raziskovanja med medicinskimi sestrami je treba prenesti rezultate raziskav v prakso, izboljšati znanje medicinskih sester tako na področju raziskovanja kot uporabe pridobljenih rezultatov v praksi.
Uvod: Za boljše doseganje kakovosti življenja pacientov s kronično obstruktivno pljučno boleznijo je slednje treba poučiti o značilnostih bolezni ter o ukrepih za njeno učinkovito samoobvladovanje. ...Namen raziskave je bil ugotoviti pogostost dokumentiranja in vrsto dokumentiranih navodil o življenjskem slogu in samoobvladovanju bolezni v bolnišnični dokumentaciji pacientov s kronično obstruktivno pljučno boleznijo.Metode: Izvedena je bila retrospektivna kvantitativna raziskava, v kateri je bila pregledana celotna bolnišnična dokumentacija (terapevtski listi, liste zdravstvene nege, arhivi zdravstvenovzgojnih šol, odpustna pisma) 253 pacientov s kronično obstruktivno pljučno boleznijo. Za analizo podatkov sta bila poleg osnovne deskriptivne statistike uporabljena tudi hi-kvadrat test in ordinalna logistična regresija.Rezultati: V bolnišnični dokumentaciji so pacienti s kronično obstruktivno pljučno boleznijo imeli dokumentirana v povprečju manj kot 4 navodila o življenjskem slogu in samoobvladovanju bolezni (x = 3,8, s = 5,1). V odpustnem pismu je polovica pacientov (x = 0,5, s = 0,9) imela zabeleženih manj navodil o življenjskem slogu in samoobvladovanju bolezni kot v bolnišnični dokumentaciji (x2 = 33,455, p < 0,001). Diplomirane medicinske sestre so navodila dokumentirale petkrat pogosteje kot zdravniki.Diskusija in zaključek: Raziskava je za bolnišnično dokumentacijo pacientov s kronično obstruktivno pljučno boleznijo ugotovila nizko število dokumentiranih navodil o življenjskem slogu in samoobvladovanju bolezni. Treba bo povečati ozaveščenost o pomenu dokumentiranja zdravstvenovzgojnih navodil in oblikovati orodja za izboljšanje medpoklicne komunikacije.
Introduction: According to different studies, student work has both positive and negative effects on the academic performance of nursing students. The purpose of the study was to examine the effect ...of student work based on a sample of Slovenian nursing students. Methods: The method of non-experimental quantitative research with a sampling survey was used. 432 nursing students participated. The reliability of the questionnaire was determined by internal consistency analysis (from 0.608 to 0.753) and factor analysis. The data were collected in October and November 2012. Descriptive statistics, the chi-square test, correlation analysis and ANOVA were used for the statistical analysis. Results: Students of four higher education institutions did not provide statistically significant differences in the assessment of their financial status (p = 0.189). The number of hours of student work does not statistically correlate (p = 0.776) with the time for studying. The monthly total of the hours of student work revealed a statistically significant difference (p = 0.001), with students at higher education institution A stating the least hours of student work (x = 19.9), and students at higher education institution B stating the greatest amount of student work (x = 48.5). Discussion and conclusion: The monthly amount of hours of student work does not affect students’ academic performance. Students opt for student work because they wish to acquire clinical experience, clinical practice, meet potential employers and improve their employment prospects after graduation.
Uvod: Dobra priprava na odpust zveča kakovost življenja bolnika s kronično obstruktivno pljučno boleznijo in zmanjša število hospitalizacij. Z namenom opredelitve zadovoljstva bolnikov s kronično ...obstruktivno pljučno boleznijo z obravnavo koordinatorja odpusta je bila izvedena neeksperimentalna kvantitativna raziskava. Metode: Raziskava je potekala anonimno, s pomočjo strukturiranega vprašalnika, poslanega po pošti. Sodelovalo je 107 bolnikov, ki so bili zaradi poslabšanja kronične obstruktivne pljučne bolezni hospitalizirani med 2. novembrom 2009 in 6. decembrom 2011 in bili obravnavani s strani koordinatorja odpusta. Vprašalnik je vrnilo 60 bolnikov. Za statistično obdelavo smo uporabili opisno statistiko, faktorsko analizo, linearnoregresijski model in multiplo linearno regresijo. Rezultati: Z analizo smo ugotovili, da lahko s skupnim vplivom treh faktorjev (komunikacija, samoobvladovanje bolezni in doživljanje bolezni oz. simptomi) pojasnimo 84,02 % variance zadovoljstva bolnikov s koordinatorjem odpusta. Z zadovoljstvom bolnikov s koordinatorja odpusta je najbolj povezana komunikacija, sledi ji doživljanje bolezni oz. simptomi. Diskusija in zaključek: Bolniki so zadovoljni z aktivnostmi koordinatorja odpusta v postopku odpusta iz bolnišnice, kar ugotavljajo tudi drugi avtorji. Raziskava pokaže na smiselnost uvedbe profila koordinatorja odpusta v obravnavo bolnikov s kronično obstruktivno pljučno boleznijo. Spremljanje zadovoljstva bolnikov je smiselno, saj pokaže priložnosti za izboljšave dela z vidika bolnika.
Uvod: Zdravstvena nega je znanstvena disciplina, zato morajo diplomirane medicinske sestre v prihodnosti z raziskovalnim delom slediti znanstvenoraziskovalnemu razvoju. Namen raziskave je bil ...ugotoviti odnos diplomiranih medicinskih sester do raziskovanja, s katerimi ovirami se srečujejo pri tem in v kolikšni meri se odločajo za raziskovalno delo. Metode: Uporabljena je bila kvantitativna neeksperimentalna metoda raziskovanja. Raziskava je bila izvedena s pomočjo strukturiranega vprašalnika med 110 diplomiranimi medicinskimi sestrami v zdravstveni dejavnosti na primarni in terciarni ravni. Zanesljivost vprašalnika je bila preverjena s koeficientom Cronbach alfa (Cronbach a = 0,72). Raziskava je bila izvedena v maju in juniju 2018. Uporabljeni sta bili opisna statistika in bivariatna analiza z Mann-Whitneyevim in Kruskal Wallisovim testom. Rezultati: Diplomirane medicinske sestre se v večini strinjajo (x = 4,23, s = 0,895), kako pomembno je, da zdravstvena nega temelji na dokazih. Oviro pri raziskovanju jim predstavljata znanje (x = 3,39, s =1,000) in pomanjkanje časa (x = 3,76, s = 0,877). Diplomirane medicinske sestre v zdravstveni dejavnosti na terciarni ravni so raziskovanju bolj naklonjene (x = 4,16) kot tiste na primarni ravni (x = 3,79, U = 1102,00, p = 0,008). Diskusija in zaključek: Diplomirane medicinske sestre se strinjajo, da je z dokazi podprta praksa v zdravstveni negi nujna. V raziskovanje se ne vključujejo zaradi pomanjkanja znanja, časa in pomanjkanja podpore sodelavcev. Za dvig ravni raziskovanja med medicinskimi sestrami je treba prenesti rezultate raziskav v prakso, izboljšati znanje medicinskih sester tako na področju raziskovanja kot uporabe pridobljenih rezultatov v praksi.
Introduction/Objective. Allergic reactions to insect stings are medical emergencies that could be prevented by venom immunotherapy (VIT). The main purpose of VIT is to prevent fatal or ...life-threatening reactions. We aimed to show the rapidity with which patients experience the benefits of VIT and estimate the number of emergency treatments that are prevented. Methods. We reviewed the medical files of patients who started VIT between 2010 and 2014. We calculated the costs of treatment of the sting reactions, the costs of immunotherapy, and estimated the costs of prevented allergic reactions. Results. In a cohort of 514 patients (40.9% female, age 47.2 ? 14.4 years), the cost of treatment of the index sting reaction was 180.4 ? 166.8 euros. During VIT, 195 patients experienced 446 field stings. In 86.3% of patients, stings were well tolerated, and only one patient experienced a severe reaction (grade III, according to Mueller). A total of 20.4% of VIT treated patients were stung during the first year of VIT and 57% during five years of VIT. The expenditure for five years of VIT was 2,886 euros per patient, which corresponded to an average of 16 emergency treatments for systemic reactions. Conclusion. Emergency situations are prevented in a substantial number of venom-allergic patients and a beneficial effect was already observed during the first year of VIT.
nema
To test whether coordination of discharge from hospital reduces hospitalizations in patients with chronic obstructive pulmonary disease (COPD).
Randomized controlled clinical trial.
Specialized ...pulmonary hospital.
Patients hospitalized for an acute exacerbation of COPD.
Care as usual included routine patient education, supervised inhaler use, respiratory physiotherapy, and disease-related communication. The discharge coordinator intervention added assessment of patient situation and homecare needs. Patients and caregivers were actively involved and empowered in the discharge planning process, which was communicated with community medical professionals to provide continuity of care at home.
The primary end-point of the study was the number of patients hospitalized because of worsening COPD. Key secondary end-points were time-to-COPD hospitalization, all-cause mortality, all-cause hospitalization, days alive and out of hospital, and health-related quality of life.
Of 253 eligible patients (71 ± 9 years, 72% men, 87% GOLD III/IV), 118 were assigned to intervention and 135 to usual care. During a follow-up of 180 days, fewer patients receiving intervention were hospitalized for COPD (14% versus 31%, P = .002) or for any cause (31% versus 44%, P = .033). In time-to-event analysis, intervention was associated with lower rates of COPD hospitalizations (P = .001). A Cox model of proportional hazards, adjusted for sex, age, GOLD stage, heart failure, malignant disease, and long-term oxygen treatment, demonstrated that intervention reduced the risk of COPD hospitalization (hazard ratio 0.43, 95% confidence interval 0.24-0.77, P = .002).
Among patients hospitalized for acute COPD exacerbation, discharge coordinator intervention reduced both COPD hospitalizations and all-cause hospitalizations.
Introduction: To achieve a better quality of life in patients with chronic obstructive pulmonary disease, these patients should be informed about the characteristics of the disease and measures for ...its effective self-management. The aim of the study was to determine the frequency and type of written instructions regarding lifestyle and self-management of the disease in hospital documentation of patients with chronic obstructive pulmonary disease. Methods: A retrospective quantitative study that reviewed all the hospital's documents (therapy forms, nursing forms, archives of health education programmes, letters of discharge) was conducted including 253 patients with chronic obstructive pulmonary disease. The results were described in terms of descriptive statistics; chisquare test and ordinal logistic regression were used. Results: On average, hospital records of patients with chronic obstructive pulmonary disease showed less than 4 instructions ( = 3.8, s = 5.1) about life style and disease self-management. Half of chronic obstructive pulmonary disease patients received letters of discharge ( = 0.5, s = 0.9) which contained less guidance about lifestyle and self-management of the disease than their hospital records (x2 = 33.455, p < 0.001). Nurses recorded the instructions five times more frequently than doctors. Discussion and conclusion: The study showed a low number of written instructions about the life style and self-management of the disease given to chronic obstructive pulmonary disease patients during hospitalization. It is necessary to raise awareness about the importance of documenting health education instructions and design tools to improve inter-professional communication.
V zdravstvu pogosto omenjamo krožke kakovosti, kot metodo dela, s katero dosegamo zadovoljstvo zaposlenih in pacientov, udeleženci prihajajo do novih spoznanj in povečujejo svojo usposobljenost za ...izvajanje delovnega procesa. Predmet empirične analize je ugotavljanje učinkovitosti modela krožkov na rezultate izbranih kazalnikov kakovosti: razjede zaradi pritiska, padci, zasebnost in informiranje. Metoda je bila vrednotena v Kliničnem oddelku za pljučne bolezni in alergijo Golnik. Rezultati: z delovanjem krožkov kakovosti je dosežena izboljšava na nekaterih področjih, merjenih s kazalniki kakovosti.
Summary Background Limited information is available about Mini Nutritional Assessment (MNA) questionnaire in patients with chronic obstructive pulmonary disease (COPD). We have conceived this ...analysis to study the associations between MNA questionnaire, body composition, and rehospitalisations in patients with COPD. Methods This prospective study recruited control subjects and COPD patients for pulmonary function testing, nutritional assessment using MNA questionnaire, body composition measurement, and dyspnoea evaluation. We recorded hospitalisations during 6 months after discharge. Results Our sample included 22 healthy controls (71 ±5 years, 59% men) and 108 COPD patients (71 ±10 years, 75% men, 85% severe or very severe COPD). MNA score was significantly higher in control subjects than in COPD patients (27.0±1.7 vs 21.2±4.9, p <0.001). MNA score decreased over GOLD stage (p = 0.02) and indicated malnutrition in 14% of patients, and further 55% were at risk of malnutrition. Body mass index but not body composition parameters was higher in control subjects when compared to COPD patients (29.1±3.8 vs 27.0±6.3, p = 0.041). A positive correlation between MNA score, body fat content (p = 0.001), and lean body mass (p <0.001) was observed. During follow-up, 45 (41%) patients were rehospitalised. Malnourished patients had higher risk of rehospitalisation in univariate analysis (HR 2.62, 95%Cl 1.13-6.07), which was maintained in an adjusted model (HR 2.93, 95%CI 1.05-7.32). Conclusions Malnutrition and risk of malnutrition was frequent, associated with lower body fat mass and lean body mass, and independently predicted hospitalisations at six months.
PDF
