Abstract Introduction Despite the high prevalence of malnutrition in patients at all levels of healthcare, early prevention and treatment of malnourished patients are often neglected and overlooked ...in clinical practice. The aim of this systematic literature review was to identify the factors considered most important by healthcare professionals in the identification and treatment of malnourished patients or those at risk of malnutrition. Methods A systematic literature review of qualitative research was conducted. Documents published in scientific journals in English from 2011 to 2021 were searched in the PubMed (MEDLINE), CINAHL and ProQuest databases. The results were analysed with a thematic analysis of qualitative research findings. Results From the search set of 1010 results, 7 sources were included in the final analysis. Factors identified by health professionals as important in the identification and treatment of malnourished patients in clinical practice were grouped into five themes: unclear organizational structure; indefinite structure of nutritional care; poor continuity of nutritional care; lack of knowledge and skills of health professionals; lack of time and human resources. Conclusions Health policy must provide resources for nutritional care for patients at all levels of health care on the initiative of the highest professional bodies at the state level. To improve the nutritional care of patients in clinical practice, the management of health care institutions must promote and enable the professional and organizational establishment of clinical nutrition as a regular medical activity of the institution, develop clinical nutritional pathways, and promote evidence-based clinical practice and interprofessional collaboration.
A low proportion of bystanders in Slovenia are willing to provide resuscitation to people experiencing cardiac arrest. We measured knowledge acquired after cardiopulmonary resuscitation training ...among Slovenian children in the final three grades of primary school.
This pre- and post-test cohort study included 566 schoolchildren aged 12-15 years. From April to May 2018, we administered a 15-item questionnaire to children in 15 primary schools, to assess the effects of theoretical and practical cardiopulmonary resuscitation training on their knowledge of cardiopulmonary resuscitation at 1-2 months after training. Data were processed using univariate, bivariate, and multivariate analyses.
A significantly greater level of post-training knowledge was noted in all three equally sized school grade groups (p=0.001). The youngest group (mean age 12.5 years) exhibited the greatest increase in knowledge, with test scores increasing by an average 2.65 (range 0-15) points. Age (p=0.001), body mass index (p=0.037), female sex (p=0.006), and previous resuscitation training (p=0.024) were significant independent predictors of pre-training knowledge level. Sex was the only predictor significantly influencing knowledge levels after training (p=0.002); girls scored up to 0.7 points higher than boys, both before and after training.
Among Slovenian schoolchildren aged 12-15 years, a significantly improved level of theoretical knowledge was demonstrated after cardiopulmonary resuscitation training. The introduction of cardiopulmonary training may be most effective in children aged 12.5 years (seventh graders). Early, compulsory resuscitation training might reduce social barriers to performing resuscitation, which may eventually translate into better post-cardiac arrest outcomes.
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.
Coronavirus disease 2019 (COVID-19) can be diagnosed as occupational disease by an occupational health physician (OHP), if supported by relevant work-related and medical documentation. The aim of ...this study was to analyse such documentation submitted by Croatian healthcare workers (HCWs) and discuss its relevance in view of European and Croatian guidelines. The study included 100 Croatian HCWs who were SARS-CoV-2-positive and requested that their infection be diagnosed as occupational disease by their OHPs from 1 May 2020 to 10 March 2021. As participants they were asked to fill out our online Occupational COVID-19 in Healthcare Workers Questionnaire. For the purpose of this study we analysed answers about the type of close contact at the workplace, COVID-19 symptoms, and enclosed work-related (job description, employer statement about exposure to SARS-CoV-2) and medical documentation (positive SARS-CoV-2 polymerase chain reaction test and patient history confirming the diagnosis of COVID-19). Most participants were working in hospitals (N=95), mostly nurses (N=75), who became infected by a patient (N=68) or colleague (N=31), and had at least one COVID-19 symptom (N=87). Eighty participants did not enclose obligatory documents, 41 of whom failed to submit job description and 31 both job description and employer statement. These findings confirm that the major risk of occupational COVID-19 in HCWs is close contact with patients and colleagues, and points out the need for better cooperation between OHPs, occupational safety experts, employers, and diseased workers.
Cilj. U radu se prikazuje izgradnja zbirki u medicinskoj knjižnici na primjeru Središnje knjižnice Kliničkog bolničkog centra Sestre milosrdnice (KBCSM) u Zagrebu, Vinogradska c. 29 i njezina dva ...ogranka.
Metodologija. Središnja knjižnice KBCSM u Zagrebu. specijalna je medicinska tj. bolnička knjižnica. Na druge dvije lokacije KBCSM djeluju njezini ogranci: Knjižnica KBCSM u Draškovićevoj 19 (u Klinici za traumatologiju KBCSM) i Knjižnica KBCSM u Ilici 197 (u Klinici za tumore KBCSM). Opisuju se zbirke knjižnične građe te izlaže sažeti pregled vrste nabave knjižnične građe.
Rezultati. Zbog prirode biomedicinskih informacija koje zastarijevaju jako brzo, za formiranje zbirki najznačajnije su zbirke periodike, baze podataka te zbirke stranih i domaćih knjiga, koje se redovito nadopunjavaju recentnim izdanjima. Početkom 21. stoljeća u biomedicini sve važnije mjesto zauzimaju e-izvori. Središnja knjižnica KBCSM izgrađuje svoje zbirke kroz nabavu tiskanih i e-izvora vlastitim sredstvima u kombinaciji s pristupom u e-izvore, koji se nabavljaju za znanstvene i akademske ustanove u RH.
Vrijednost rada. U radu se zaključuje da Središnja knjižnica KBCSM izgradnjom svojih zbirki na način opisan u ovom radu, uspješno ispunjava temeljnu zadaću velike bolničke knjižnice, a to je potpora stručnom, znanstveno-nastavnom i istraživačkom radu djelatnika KBC Sestre milosrdnice, ali i vanjskih korisnika.
Rad je kombinacija usmenog i posterskog izlaganja sa stručnog skupa „ Izgradnja, upravljanje i evaluacija zbirki” održanog u Nacionalnoj i sveučilišnoj knjižnici u Zagrebu 12.04.2019.
Cilj ovog kvalitativnog istraživanja bio je dobiti uvid u izvore profesionalnog stresa medicinskih sestara u domovima za starije osobe, njegove znakove te činitelje zaštite u suočavanju s istim. U ...istraživanju je sudjelovalo 11 medicinskih sestara zaposlenih u domovima za starije osobe u Gradu Zagrebu, a koji su u nadležnosti Gradskog ureda za socijalnu zaštitu i osobe s invaliditetom. Podaci su prikupljeni metodom polustrukturiranog intervjua. Nalazi su pokazali da iz perspektive medicinskih sestara u domovima za starije osobe izvori profesionalnog stresa predstavljaju: organizacijski uvjeti rada (nedostatak stručnog osoblja i rad u smjenama), priroda posla, koja uključuje iskustvo suočavanja sa smrću korisnika te rad s korisnicima s problemima mentalnog zdravlja (korisnika oboljelih od Alzheimerove bolesti) i komunikacije sa članovima obitelji korisnika. Sudionice istraživanja kao tjelesne znakove stresa ističu sljedeće pokazatelje: znojenje, probavne smetnje, gubitak apetita, teškoće sa spavanjem, želučane tegobe, glavobolja, umor i aritmija. Psihološke posljedica stresa se kod sudionica manifestira kroz osjećaj tuge i potištenosti, nervoze i osjećaja napetosti. Neki od činitelja zaštite u suočavanju s navedenim izvorima stresa su aktivno suočavanje sa stresom, radno okruženje, formalni oblici podrške. Budući da je područje stresa u profesionalnih pomagača u radu sa starijim osobama relativno neistraženo područje, dobiveni nalazi mogu poslužiti kao uvid u ključna pitanja i područja unapređenja rada u domovima socijalne skrbi. U tom smislu posebice je važno uvođenje profesionalne podrške djelatnicima u osiguravanju kvalitete rada. Također, dobiveni rezultati mogu se koristiti kao polazna točka i smjernica za daljnja istraživanja u području stresa profesionalnih pomagača koji rade sa starijim osobama.
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.
The aim of this literature review was to explore the views of parents and children with type 1 diabetes mellitus regarding having a school nurse.
Six databases were selected for the analysis. The ...research strategy was based on the PICO model. The research participants were children with type 1 diabetes mellitus and/or their parents.
The present review of research papers includes 12 publications. The majority of works deal with the perspectives of children with type 1 diabetes and their parents on various aspects related to the role of a school nurse in the care of a child with type 1 diabetes:the presence of a school nurse;the role of a school nurse in the prevention and treatment of hypoglycaemia, in performing the measurements of blood glucose, and in insulin therapy;the role of a nurse in improving metabolic control of children with type 1 diabetes;a nurse as an educator for children with type 1 diabetes, classmates, teachers, teacher's assistants, principals, administrators, cafeteria workers, coaches, gym teachers, bus drivers, and school office staff;a nurse as an organiser of the care for children with type 1 diabetes.
According to parents and children with type 1 diabetes mellitus, various forms of school nurse support (i.e., checking blood glucose, giving insulin, giving glucagon, treating low and high blood glucose levels, carbohydrate counting) are consistently effective and should have an impact on the condition, improvement of metabolic control, school activity and safety at school.
Protection at work and work safety are the basic principles of the human right to work in a dignified way that guarantees protection of life and health at work. The scope of work of ...nurses/technicians includes diagnostic procedures, treatment and patient care. However, performance of these tasks can lead to health damage. Preventing and reducing injuries, occupational diseases, diseases related to the work as well as the preservation and improvement of health have a huge impact on reducing economic losses. Thus, a building of awareness is required so that the investment in occupational safety and health and safety at work will not be perceived as an unnecessary expense or a huge cost, but a long-term profitable investment. Additional costs and major expenses arise when the safety and health at work are not in proper focus. Employers and employees are the key factors, but the most important effort is to start raising awareness about the importance of protection and safety at work during the training for certain professions. Teachers play an important role in developing positive attitudes and understanding the importance of prevention of occupational accidents, occupational and related diseases. They greatly influence the maintenance of protection and safety from the earliest days to the end of service, including even the life expectancy of an individual person. If future young health care workers start with the acquisition of knowledge and skills of work safety at the beginning of their professional training, then safety and protection at work will become an integral part of the working process for them. They will develop a proper attitude toward the importance of occupational safety and health, which will guide them throughout their entire working life.
Zaštita i sigurnost na radu temelj su za ostvarivanje prava čovjeka na rad na dostojanstven način, za zaštitu života i zaštitu zdravlja. Djelokrug rada medicinskih sestara/tehničara obuhvaća radne zadatke koji uključuju dijagnostičke postupke, liječenje i skrb za oboljele, a obavljanje tih radnih zadataka može dovesti do oštećenja zdravlja. Sprečavanje i smanjenje ozljeda na radu, profesionalnih bolesti i bolesti u vezi s radom te očuvanje i unapređivanje zdravlja ima velik utjecaj i na gospodarske gubitke. Potreban je proces osvješćivanja za ulaganje u zaštitu na radu kako rad na siguran način ne bi bio shvaćen kao nepotreban veliki trošak, već dugoročno isplativa investicija. Dodatan ili veliki trošak nastaje kada sigurnost i zdravlje na radu nisu u odgovarajućem fokusu. Poslodavci i zaposlenici su ključni čimbenici, ali od svega je najbitnije započeti osvješćivanje o važnosti zaštite i sigurnosti na radu tijekom stjecanja znanja za određena zanimanja. Nastavnici imaju značajnu ulogu u razvijanju pozitivnih stajališta i razumijevanju važnosti prevencije nastanka nezgoda na radu, profesionalnih bolesti i bolesti u vezi s radom. Njihova uloga uvelike utječe na održavanje zaštite i sigurnosti na radu od najranijih dana do kraja radnog staža, ali i životnog vijeka pojedinca. Ako budući mladi radnici počnu sa stjecanjem znanja i vještina o zaštiti i sigurnosti na radu na početku svoje stručne izobrazbe, tada sigurnost i zaštita na radu za njih postaju sastavni dio radnog procesa. Pri tom razvijaju dobar odnos prema važnosti zaštite i sigurnosti na radu te prema zdravlju koji će ih pratiti tijekom njihova cijelog radnog vijeka.
Pad bolesnika klasificira se u neželjene događaje te je jedan od pokazatelja sigurnosti bolesnika i indikator kvalitete zdravstvene njege, ali i najčešće prijavljivan neželjeni događaj u zdravstvenim ...ustanovama. U prevenciji pada uz adekvatnu procjenu rizika ukazala se potreba istraživanja i potencijalnih pretkazatelja pada. Hiponatrijemija zadnje desetljeće postaje i predmet istraživanja u prevenciji pada. Cilj rada je identificirati kritične čimbenike rizika za pad i utvrditi može li hiponatrijemija u serumu poslužiti kao pretkazatelj pada u kategoriji neočekivanog fiziološkog pada, kojeg prati sestra u okviru sklopu kompetencija.
Provedeno istraživanje bilo je retrospektivno, a uzorak je sačinjavalo 77 padova bolesnika na Zavodu za intenzivno kardiološko liječenje, aritmije i transplantacijsku kardiologiju, Kliničkog bolničkog centra Zagreb u razdoblju od 1.1.2010. do 31.12.2018. godine. Ispitivali su se vrijeme, mjesto, uzroci i posljedice padova, određivao se rizik za pad i kategoriju pada po sustavu kategorizacije pada Janice Morse te koncentracija natrija u serumu.
Podaci obrađeni hi-kvadrat testom nezavisnosti nije pokazao statistički značajnu vezu (2 = 1,033, P = 0,597) između hiponatrijemije i neočekivanog fiziološkog pada, međutim Phi je 0,112 te se po Koenovom kriteriju smatra da postoji mali utjecaj razine natrija na kategoriju pada u ovom istraživanju.
Dobivene rezultate treba promatrati u svjetlu malog broja ispitanih padova i unatoč nepostojanju statistički značajne veze, ovi podaci ukazuju na potrebu daljnjeg istraživanja utjecaja hiponatrijemije kao pretkazatelja pada kardiološkog bolesnika, pri čemu je uloga medicinske sestre iznimno istaknuta.
Patient’s fall is classified as an adverse event and it is one of the indicators of patient safety and an indicator of the quality of health care, but also the most commonly reported adverse event in healthcare institutions. Fall prevention with adequate risk assessment has highlighted the need to investigate fall predictors. Hyponatremia has been associated with many risk factors and has become the subject of research in fall prevention in the last decade. The aim of this study was to identify critical factors for fall risk and explore hyponatremia (monitored by nurse) as a possible predictor for physiological fall.
The study investigated 77 reported patient falls at the Department of Intensive Cardiac Care, Arrhythmias and Transplant Cardiology, Clinical Hospital Center Zagreb, in the period from 1.1.2010. to 31.12.2018. We examined the time, location, causes, and consequences of each fall, as well as the risk for fall and fall category relying on Janice Morse’s fall categorization system, as well as the concentration of serum sodium. The Chi-square test of independence did not show a statistically significant relation (2 = 1.033, P = 0.597) between the decreased serum sodium level and the unexpected physiological fall. However, Phi is 0.112 and, according to Koen’s criterion, there is a small influence of sodium level on the fall category in this research.
Results should be regarded with caution due to the relatively small number of investigated cases. However, despite the weak statistical correlation, these data indicate the need to further investigate the impact of hyponatremia as a predictor of cardiac patient falls.
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