Izhodišča: Nenujne kontrolne obravnave na sekundarni ali terciarni ravni pogosto določi napotni zdravnik sam ob zadnji obravnavi. Po preteku veljavnosti predhodne napotnice mora družinski zdravnik ...le-to ponovno izdati oz. opredeliti, da je potrebna. Ob vse večjih administrativnih obremenitvah družinskih zdravnikov se zdi dodatna vloga družinskega zdravnika kot t. i. »vratarja« pri izdajanju nenujnih kontrolnih napotnic nepotrebna. Cilj te študije je izračunati stroškovno in časovno obremenitev zaradi izdajanja nenujnih kontrolnih napotnic in predlagati bolj smotrno ureditev.
Metode: Gre za presečno kvantitativno študijo. Podatki o izdanih napotnicah in skupno opravljenem delu izvirajo iz avtomatskega beleženja statističnih podatkov v računalniškem programu IRIS. Zbrani so za devet ambulant družinske medicine v enoti Center Zdravstvenega doma Ljubljana v obdobju od 1. 3. 2018 do 30. 6. 2018.
Rezultati: Skupno je bilo pregledanih 7.340 napotnic. Kontrolne napotitve so predstavljale 37 % (2.720 napotnic) vseh napotitev oz. 75 napotnic mesečno na ambulanto. Od tega jih je bilo 90 % (2.453 napotnic) izdanih zaradi nenujnega bolezenskega stanja. Kar 86 % (2.104 napotnic) nenujnih kontrolnih napotnic je bilo izdanih brez opravljenega kliničnega pregleda. Za izdajanje nenujnih kontrolnih napotnic je družinski zdravnik povprečno porabil 68 minut na teden (3,5 % delovnega časa). Porabljeni čas ustreza 10 obravnavam bolnika v ambulanti družinskega zdravnika. Za izdajanje kontrolnih napotnic je ambulanta družinske medicine povprečno mesečno obračunala 255 € oz. 6 % vseh obračunanih storitev. Mesečni strošek za vse zdravstvene time v Sloveniji na račun napotnic bi tako znašal 203.191 €, mesečna časovna obremenitev pa 2,8 % delovnega časa.
Zaključek: Administrativna obremenitev zaradi izdajanja nenujnih kontrolnih napotnic tako po času kot tudi stroških pretirano obremenjuje ambulante družinskega zdravnika, na da bi pri tem družinski zdravnik imel bistveno strokovno vlogo. Zato članek predstavi model ureditve izdajanja napotnic, ki bi odpravil nepotrebne administrativne obremenitve ter omogočil bolj sistematizirano napotovanje akutnih poslabšanj pri kroničnih boleznih.
Surveys conducted among healthcare workers revealed that nursing staff often face various stressors associated with occupational activities, which reduce their work efficiency. The aim of the study ...was to establish the level of stress in nurses working at hospitals in Slovenia and to identify stress-related factors.
A cross-sectional epidemiological design and a standardized instrument called the "Nursing stress scale" were used. The sample included 983 nurses from 21 Slovenian hospitals. The research was conducted in 2016.
Prevalence of high level of stress was 56.5% of respondents (M (median)=75). Prevalence of high level of stress and stress factors may be statistically significant attributable to dissatisfaction at work (p<0.001), disturbing factors at work (p<0.001), inability to take time off in lieu after working on weekend (p=0.003), shorter serving (p=0.009), fixed-term work (p=0.007), and an increased number of workdays on Sunday (p=0.030).
The stress rate and stress factors are substantially influenced by variables reflecting work organization, competences and skills of healthcare management to work with people. Results reflect the need for nursing management and policy makers to design strategies to ensure adequate staffing, efficient organization and an encouraging work environment.
Published research studies in Central Europe have been mostly oriented toward occupational stress among schoolteachers. The aim of this study is to investigate the level of occupational stress in ...kindergarten teachers and to specify psychosocial risks associated with their work.
The study was conducted by using a Meister questionnaire and a Psychosocial risk questionnaire. The data collection was obtained from kindergarten teachers in 2017. The survey link with request was sent to participants via email. A total 287 questionnaires from 67 kindergarten schools were collected.
192 (66.9%) teachers perceived their work as mentally burdensome. Teachers who perceived their work as mentally non-burdening were more likely to report autonomy in their work (p=0.001), fair performance evaluation (p=0.010), sufficient family time (p=0.005), a health-protected workplace (p=0.000) and absence of violence and bullying (p=0.042). Teachers with a university degree perceiving work as mentally burdensome reported that their work was not adequately assessed (p=0.034). Teachers over 45 years of age with school practice of over 20 years reported injustice in evaluating work performance against younger colleagues (p=0.000).
Kindergarten teachers reported overloading, time pressure, and high responsibility, but considered their work interesting. However, changing the way teachers work in schools can reduce teacher resignation and improve teachers' well-being.
The voice represents a basic working tool for carrying out certain occupations. Hoarseness, as a consequence of vocal fold lesions, presents an important cause of work-related absences for voice ...professionals.
Our study was designed as a retrospective cohort one. Data on gender, workplace, vocal load and exposure to risk factors for voice disorders of the patients who had surgery in the 2014-2015 period at the tertiary centre due to benign vocal fold lesions were collected from their clinical records. We compared professional voice users (PVU) to subjects with no vocal load at work (NPVU). The SPSS programme, version 22.0, was used for statistical analysis.
From 2014 to 2015, 103 PVU and 132 NPVU were surgically treated for benign vocal fold lesions. In comparison to the second group, loud speech use was reported significantly more often by PVU (40.8% vs. 14.4%), as was a fast speaking rate (22.3% vs. 9.8%) and additional vocal load outside of the workplace (23.3% vs. 12.9%). The time that had passed between the occurrence of the hoarseness and the surgical treatment did not differ between the groups. The majority of patients were satisfied with the outcome of the operation.
Nearly a half of the operated patients had a considerable vocal load at work. An ENT assessment prior to starting a job as well as priority phoniatric treatment of voice disorders for PVU would significantly reduce the costs of work absences and contribute to a speedier recovery and return to the workplace.
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