Assessment of patient safety perception nurses in health system of Bosnia and Herzegovina in COVID period: Descriptive and cross-sectional study

Introduction: Patient safety depends on a number of factors such as teamwork, working climate, employee satisfaction, work environment, stress awareness, management perception, and attitude. Nurses have a key role to play in protecting and supporting patients, and their assessment serves as a reliable predictor of overall hospital safety. A positive attitude toward patient safety is associated with a significant reduction in complications. The aim of the study was to analyze the perception of nurses about all aspects of patient safety in relation to the workplace and length of service. Methods: The research included 647 nurses employed in health care institutions at the primary, secondary, and tertiary levels of health care. A descriptive and cross-sectional study included nurses from the Federation of Bosnia and Herzegovina. It was conducted in the period from November to December 2021, during the COVID pandemic. A standardized questionnaire on the perception of patient safety was used – Safety Attitudes Questionnaire – SAQ. Results: The analysis of the examined factors in relation to the workplace of the respondents revealed a statistically significant difference in job satisfaction (p < 0.001), as well as in the safety climate at work in relation to the workplace (p = 0.005), working conditions (p < 0.001), and management perception (p < 0.001). Stress levels showed significant differences regarding working position (p = 0.017), but also through the years of service (p = 0.012). Stress was significantly correlated with teamwork (r = 0.124; p = 0.003), showing that better teamwork will help with stress. Conclusion: The synthesis of concepts that includes patient safety and orientation toward patients should be implemented as a strategic quality orientation and set as a priority of every health care system

Acute descending necrotizing mediastinitis as a complication of the retropharyngeal abscess caused by anaerobes

Descending necrotizing mediastinitis (DNM) is a rare, life-threatening form of mediastinitis caused by odontogenic, pharyngeal, or cervical infections. The retropharyngeal space is the most common primary site of infection. Given the fulminant course and high mortality rate, early diagnosis and prompt treatment are important predictors of survival in patients with DNM. Appropriate empirical antibiotic treatment, prompt surgical intervention, and proper management of patients in the intensive care unit can be of vital importance. We present the case of a previously healthy 20-year-old male patient who was successfully cured and discharged from the Clinical Center University of Sarajevo after suffering from a severe form of mediastinitis as a complication of the retropharyngeal abscess caused by anaerobes

Thoracosurgical treatment of pleural complications in patients with coronavirus disease 2019 (COVID-19): A cross-sectional study

Introduction: Pleural complications in coronavirus disease 2019 (COVID-19) are relatively uncommon findings. Pleural involvement in these patients may directly correlate to disease severity and overall prognosis. We aimed to review clinical features and treatment approaches for pleural complications (accumulation of fluid/air inside the pleural cavity) in 45 patients with COVID-19, who were treated at our institution between April 2020 and October 2021. Methods: Our study was designed as single-center, observational, cross-sectional study of 45 patients with COVID-19 and at least one radiologically verified pleural complication. Demographic data, radiological findings, as well as type and number of thoracosurgical intervention(s) were recorded for every patient. We included patients of both genders and various age groups, with positive RT-PCR assay for COVID-19 and radiologic features of pleural complications, which required single or multiple thoracosurgical interventions. Results: Unilateral pleural complications were more common, right-sided pleural complications were found in 44.4% of patients. Right-sided pneumothorax was reported in 26.7% of patients. Almost one-fourth of our patients required invasive mechanical ventilation. Tube thoracostomy was performed in 84.4% of patients with unilateral pleural complications. A fatal outcome was most common in patients over 60 years old. More than half of patients with bilateral pleural complications died in our study. Conclusions: Pleural complications are a rare finding in patients with COVID-19. Tube thoracostomy is the mainstay of treatment for most symptomatic patients with pleural complications. Future research should be directed toward investigation of long-term pulmonary consequences in patients with COVID-19