Missed and unfinished nursing care in hospitals depends on the quality of human resources. This paper aims to analyze the influence of selected work characteristics on missing and incomplete nursing ...care in inpatient wards of Czech hospitals. The relationship between the rate of missed and unfinished nursing care and selected work characteristics was studied using the Czech version of the standardized questionnaire, the MISSCARE Survey. The study was conducted from September 26, 2021, to October 15, 2021. Controlled interviews with 1,205 nurses working in ward blocks in Czech hospitals were used. The research results showed statistically significant connections between selected work characteristics and missed and unfinished nursing care. Nurses with the highest level of education (Master, Ph.D.), nurses with specialized education, nurses with the lowest number of working hours (less than 30 hours per week), and nurses with the highest number of years of work experience (21 years and over) show a significantly lower rate of missed nursing care. Nurses from surgical departments, specialist nurses, and nurses with the highest education (Master, Ph.D.) report statistically significantly lower unfinished care levels. In contrast, nurses from regional/district hospitals, practical nurses/nursing assistants, and nurses with the lowest education (secondary school of nursing) report significantly higher unfinished nursing care levels. The information obtained can be used to improve nursing processes in the identified weak parts, strategic planning of nursing care, and sufficient personnel. AcknowledgmentsI would like to express my gratitude to co-authors and other members of the research team – Hana Hajduchová, Chloubová Ivana, Hana Kubešová, Josef Malý, Martin Doseděl, Ondřej Tesař, and Kateřina Malá-Ládová, without whose support the article could not have been published.Supported by the Ministry of Health of the Czech Republic, grant no. NU20-09-00257. All rights reserved.
Patient falls deteriorate patients' functional condition and quality of life, and increase their treatment costs. E-learning is considered an effective way to gain knowledge and competencies for ...quality and safety in nursing practice. The aim of the study is to evaluate the effectiveness of an e-learning course for nurses in preventing in-patient falls.
The research design was mixed. In the first phase of the study, a five-year retrospective analysis of 2,280 in-patient falls was performed. Based on the analysis of risk factors for patient falls and group interviews with clinic managers an e-learning course was designed and completed by 250 nurses from five surgical and internal departments. The course's effectiveness was evaluated based on the incidence of patient falls and the consequences of the falls before and after e-learning.
At surgical departments, there was a statistically significant decrease in patient fall indices after the implementation of the e-learning course (from 4.4 to 2.6 falls per 1,000 patients; p=0.022). On the contrary, in internal departments, this index increased in the monitored period (from 19.0 to 26.9 falls per 1,000 patients; p=0.001). In all departments, there was a decrease in the incidence of patient injuries caused by falls after the implementation of the e-learning course; in internal medicine, this decrease was statistically significant (from 54.5% to 33.3%; p=0.014).
The study confirmed that e-learning forms of education for healthcare professionals have a positive effect in preventing patient falls.
The multifaceted benefits of breastfeeding for mothers and infants include enhanced neurodevelopment and immune function in preterm infants. However, more research is needed to understand the unique ...factors affecting breastfeeding practices in preterm infants. This study aimed to identify key social predictors of breastfeeding in preterm infants and assess the effectiveness of specific interventions on their feeding practices during the first six months postpartum.
A prospective, monocentric, longitudinal study involving a cohort of 201 preterm infants was executed at the Neonatology Department, Ceske Budejovice Hospital, Czech Republic, from January 2020 to January 2023. The STROBE guidelines were used.
The study results elucidated a transition from breastfeeding to bottle feeding and formula within the infants' first six months. Notable social predictors of breastfeeding encompassed factors such as the number of children in the household, the mother's marital status, and the nature of housing. Certain interventions, including immediate skin-to-skin contact between mother and child, and initiation of nutritive feeding within the first half-hour post-birth, significantly influenced the probability of breastfeeding.
The data underscored that social predictors and nursing interventions substantially shape the breastfeeding practices of preterm infants during the first six months postpartum. Inequities in health outcomes among premature infants can be effectively curbed through comprehensive care models that account for socioeconomic factors influencing breastfeeding.
Medication administration errors (MAE) are a worldwide issue affecting the safety of hospitalized patients. Through the early identification of potential causes, it is possible to increase the safety ...of medication administration (MA) in clinical nursing. The study aimed to identify potential risk factors affecting drug administration in inpatient wards in the Czech Republic.
A descriptive correlation study through a non-standardized questionnaire was used. Data were collected from September 29 to October 15, 2021, from nurses in the Czech Republic. For statistical analysis, the authors used SPSS vers. 28 (IBM Corp., Armonk, NY, USA).
The research sample consisted of 1205 nurses. The authors found that there was a statistically significant relationship between nurse education (p = 0.05), interruptions, preparation of medicines outside the patient rooms (p < 0.001), inadequate patient identification (p < 0.01), large numbers of patients assigned per nurse (p < 0.001), use of team nursing care and administration of generic substitution and an MAE.
The results of the study point to the weaknesses of medication administration in selected clinical departments in hospitals. The authors found that several factors, such as high patient ratio per nurse, lack of patient identification, and interruption during medication preparation of nurses, can increase the prevalence of MAE. Nurses who have completed MSc and PhD education have a lower incidence of MAE. More research is needed to identify other causes of medication administration errors. Improving the safety culture is the most critical challenge for today's healthcare industry. Education for nurses can be an effective way to reduce MAEs by enhancing their knowledge and skills, mainly focusing on increasing adherence to safe medication preparation and administration and a better understanding of medication pharmacodynamics. Med Pr. 2023;74(2):85-92.
The aim of the study was to identify the reasons for medication administration errors, describe the barriers in their reporting and estimate the number of reported medication administration errors.
...Providing quality and safe healthcare is a key priority for all health systems. Medication administration error belongs to the more common mistakes committed in nursing practice. Prevention of medication administration errors must therefore be an integral part of nursing education.
A descriptive and cross-sectional design was used for this study.
Sociological representative research was carried out using the standardized Medication Administration Error Survey. The research study involved 1205 nurses working in hospitals in the Czech Republic. Field surveys were carried out in September and October 2021. Descriptive statistics, Pearson’s and Chi-square automatic interaction detection were used to analyze the data. The STROBE guideline was used.
Among the most frequent causes of medication administration errors belong name (4.1 ± 1.4) and packaging similarity between different drugs (3.7 ± 1.4), the substitution of brand drugs by cheaper generics (3.6 ± 1.5), frequent interruptions during the preparation and administration of drugs (3.6 ± 1.5) and illegible medical records (3.5 ± 1.5). Not all medication administration errors are reported by nurses. The reasons for non-reporting of such errors include fear of being blamed for a decline in patient health (3.5 ± 1.5), fear of negative feelings from patients or family towards the nurse or legal liability (3.5 ± 1.6) and repressive responses by hospital management (3.3 ± 1.5). Most nurses (two-thirds) stated that less than 20 % of medication administration errors were reported. Older nurses reported statistically significantly fewer medication administration errors concerning non-intravenous drugs than younger nurses (p < 0.001). At the same time, nurses with more clinical experience (≥ 21 years) give significantly lower estimates of medication administration errors than nurses with less clinical practice (p < 0.001).
Patient safety training should take place at all levels of nursing education. The standardized Medication Administration Error survey is useful for clinical practice managers. It allows for the identification of medication administration error causes and offers preventive and corrective measures that can be implemented. Measures to reduce medication administration errors include developing a non-punitive adverse event reporting system, introducing electronic prescriptions of medicines, involving clinical pharmacists in the pharmacotherapy process and providing nurses with regular comprehensive training.
Hospitals strive, over the long term, to reduce the incidence of falls of hospitalized patients. Falls are monitored, analyzed, and regularly evaluated and corrective and preventive actions are ...established based on the findings. To establish preventive actions, it is essential to determine the circumstances under which the patient fell and in what type of health care facility.
The goal of the study consisted in retrospectively analyzing falls in selected hospitals of the South Bohemian Region in 2014 and 2015.
Our retrospective analysis of 1101 patient falls was reported by the health care staff from 4 hospitals of the South Bohemian Region. The data from the reported incidents (i.e., falls) from individual hospitals were encoded and entered in a database using the SASD statistical program and subsequently subjected to statistical analysis.
The highest frequency of falls was found on internal wards, 565 (51.3%) with the second highest frequency found on subsequent care wards, 267 (24.3%). The study showed that the risk of falls increases with patient age; more than 60% the hospitals, in the monitored period, involved patients over 70 years of age. Falls occurred most frequently in patient rooms and in bathrooms. Statistically significant relationships were identified between the type of ward and the time of the fall, between the type of the ward and the location of the fall, between patient age and the time of the fall, between patient age and the location of the fall, between the time of fall and the location of fall, and between the location of fall and the patient mobility before the fall.
Intensive monitoring of patient falls and the circumstances under which the falls occurred are needed to fully understand the epidemiology of hospital falls.
The study aimed to identify the occurrence of medication administration errors in clinical practice.
This was a direct observational study. The study included observing the medication administration ...process over three years in four hospitals in the Czech Republic. STROBE was used as a checklist.
A total of 18,370 medication administrations to hospitalized patients were observed and recorded, including morning, noon, and evening administrations. The most common MAE was substituting a prescribed medication without the doctor’s consent, especially among nurses aged 35-44 (p < 0.001). These MAEs involved giving a medication of diff erent strength than prescribed (p < 0.001), giving the wrong medication (p < 0.001), and giving a diff erent dose (p < 0.001). Substitutions of MAEs occurred most often during morning medication administration (p < 0.001).
A critical fi nding of this study was the substitution of medications without a doctor’s consent. It has been found that MAEs were not uncommon in clinical practice, and factors such as the nurse’s age, overall length of clinical practice, education, and workplace interruptions played a role.
This investigation examined to what extent a selected group of immigrants in the Czech Republic receive healthcare for primary prevention and inpatient care. A partial aim of the research was to ...confirm the connection between immigrant health and their social situation.
Using a quantitative study technique, 1,014 legally established immigrants (Vietnamese, Polish, Ukrainian, Russian, and Slovak) between 18-65 years of age were interviewed. The selection of respondents was conducted using purposive selection. The stratification of the group was determined by nationality, age, and gender.
Long-term illnesses were found significantly more frequently among Ukrainian immigrants and less frequently among Vietnamese immigrants. About half of the respondents had visited a GP and dentist in the previous year and 11.5% of respondents had been hospitalized in inpatient departments. Most of the surveyed immigrants had public health insurance (77.9%), one-fifth had contractual health insurance (19.6%) and 2.5% did not have health insurance. In statistical terms, Vietnamese, Ukrainian, and Russian immigrants had commercial insurance more often than Polish and Slovak immigrants. The utilization of public health insurance and healthcare among immigrants grew significantly in correlation with length of residency. The use of GPs for preventive health care also grew in correlation with knowledge of the Czech language. We found that less than nine percent of immigrants reported needing hospitalization for an illness, but were not hospitalized.
Currently, immigration represents one of the most burning and sensitive global challenges. The outcome of this research clearly shows that improving immigrant Czech language skills and giving all legally established immigrants access to Czech public health insurance are important steps needed to increase access to healthcare for immigrants in the Czech Republic.
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