Mierniki jakości w opiece długoterminowej w kontekście oceny jakości usług medycznych

Introduction. Talking about the quality of care most often think of patient satisfaction and quality certificates or accreditation. However, the problem is much more complex, especially in long-term care. There is no clear and objective indicators of quality of service, which properly documented and processed allow evaluation and comparison of care providers in this field. Objective. The aim of the study was to present issues related to the quality of care in long-term care. Material and methods. The study used the research method of reviewing the available literature, the technique was to analyze the content of articles related to the subject matter. Overview. Quality in health care is an important element of the medical service provided, which has a significant impact on patient safety and satisfaction. Quality in long-term care of long-term care facilities is both ZOL-e ZPO and nursing homes, because long-term care is a complex socio-political issue that covers the entire range of services for dependent people, disabled people who need support in basic everyday activities. Measures of the quality of care are indicators based on scientific evidence (Evidence-based medicine - EBM). Conclusions. The quality-of-care survey is a very important indicator of the assessment of the facility in terms of respecting the patient's rights.Wstęp. Mówiąc o jakości opieki medycznej najczęściej myślimy o zadowoleniu pacjenta i certyfikatach jakości lub akredytacji. Jednak problem jest o wiele bardziej złożony, szczególnie w opiece długoterminowej. Brak jest bowiem jednoznacznych i obiektywnych wskaźników jakości usług, które właściwie dokumentowane i przetwarzane umożliwiłyby ocenę oraz porównywanie świadczeniodawców w tym zakresie. Cel. Celem pracy było przedstawienie zagadnień dotyczących jakości opieki w opiece długoterminowej. Materiał i metody. W pracy wykorzystano metodę badawczą przegląd dostępnej literatury, techniką była analiza treści artykułów powiązanych z przedmiotowym zagadnieniem. Przegląd. Jakość w ochronie zdrowia to istotny element realizowanego świadczenia medycznego co w istotny sposób wpływ na bezpieczeństwo i satysfakcję pacjenta. Jakość w opiece długoterminowej placówki opieki długoterminowej to zarówno ZOL-e ZPO oraz domy pomocy społecznej, gdyż opieka długoterminowa jest złożoną kwestią społeczno-polityczną, która obejmuje cały zakres usług dla osób niesamodzielnych, niepełnosprawnych, potrzebujących wsparcia w realizacji podstawowych, czynności dnia codziennego. Mierniki jakości opieki to wskaźniki powstałe w oparciu o dowody naukowe (Evidence-based medicine -EBM). Wnioski. Badanie jakości opieki jest bardzo istotnym wskaźnikiem oceny placówki w zakresie respektowania praw pacjenta

Rationing of nursing care in Internal Medicine Departments—a cross-sectional study

Background: Implicit rationing of nursing care refers to a situation in which necessary nursing care is not performed to meet all of the patients’ needs. Purpose: To examine the factors influencing the rationing of nursing care, nurses’ assessment of the quality of patient care, and their job satisfaction in Internal Medicine Departments. Methods: A cross-sectional descriptive study was undertaken. The study included 1164 nurses working in the Internal Medicine Departments in 8 hospitals (Lower Silesia, Poland). The Perceived Implicit Rationing of Nursing Care instrument was used. Results: Respondents rarely ration nursing care, with a mean score of 1.12 (SD = 0.68). The mean score for quality of patient care was 6.99 (SD = 1.92). In contrast, the mean job satisfaction score was 6.07 points (SD = 2.22). The most important predictors of high rates of rationing of nursing care were work experience of 16–20 years (regression parameter: 0.387) and a Bachelor’s degree in nursing (regression parameter: 0.139). Nurses’ assessment of the quality of patient care ratings were increased by having a Master’s degree in nursing (regression parameter: 0.41), and significantly decreased by work experience of 16–20 years (regression parameter: -1.332). Independent predictors of job satisfaction ratings in both univariate and multivariate analysis were Master’s degree and long-shift working patterns. Conclusion: The factors that influence an increased level of nursing care rationing on medical wards are nurse seniority, exceeding 16 years and female gender. Obtaining a Master’s degree in nursing indicates improved nurses’ assessment of the quality of patient care

Trudności w żywieniu pacjentów w zaawansowanym stadium demencji – analiza przekonań norweskiego i polskiego personelu opiekuńczego

Background. Feeding difficulties in severely demented patients present a significant challenge for all involved in care. ecent studies have found that there are differences between nurse’s attitudes toward artificial nutrition and hydration in different countries. Objectives.the aim of the study was to offer an analysis of convictions of norwegian and Polish caring staff toward feeding problems in patients with advanced dementia and explore the w ay they cope with such situations. Material and methods.the data was collected in the “engensenteret” nursing home in Bergen (Norway) and in Medical centre nursing home in Brzeg (Poland). the study group comprised 52 participants and involved staff taking care of severely demented patients. a self-constructed questionnaire was used. Results.contrary to the norwegians, all Polish respondents favored forced feeding of severely demented patients. almost half of respondents suggested that any decisions about aggressive feeding should be made separately by physician and none would offer decision-making power to the patient’s family. Polish respondents stated significantly more often that artificial nutrition will improve quality of life in demented patients. Conclusions 1. the convictions of norwegian and Polish respondents according introduction of artificial nutrition in end-stage dementia and its efficiency in this population were significantly different. 2. the respondents of both nations would generally delegate the decision-making power separately to the physician. 3. the development of nutritional guidelines for advanced dementia and correction of common misconceptions about the effectiveness of aggressive nutritional intervention in this popu lation is recommended.Wstęp. Trudności w odżywianiu pacjentów w zaawansowanej demencji stanowią ogromne wyzwanie dla personelu sprawującego nad nimi opiekę. Liczne badania potwierdziły, że postawy pielęgniarek wobec problemu sztucznego odżywienia i nawadniania pacjentów są różne w poszczególnych państwach. Cel pracy. Analiza przekonań norweskiego i polskiego personelu opiekuńczego, dotyczących problemów w odżywianiu występujących u pacjentów z zaawansowaną demencją i wyjaśnienie, jak respondenci sobie z nimi radzili. Materiał i metody. Badanie przeprowadzono w domu opieki “Engensenteret” w Bergen (Norwegia) oraz w Zakładzie Opiekuńczo- Leczniczym Brzeskiego Centrum Medycznego w Brzegu (Polska). Grupa badana składała się z 52 członków personelu opiekuńczego. Jako narzędzia badawczego użyto kwestionariusza własnej konstrukcji. Wyniki. Wszyscy polscy respondenci, w przeciwieństwie do grupy norweskiej, opowiadali się za przymusowym karmieniem pacjentów z zaawansowaną demencją. Prawie połowa respondentów twierdziła, iż każdą decyzję dotyczącą sztucznego odżywiania i nawadniania powinien podjąć lekarz, nikt z badanych nie oddałby prawa decyzji w tej sprawie rodzinie chorego. Polscy respondenci twierdzili istotnie częściej, że sztuczne odżywianie poprawia ogólną jakość życia chorego na demencję. Wnioski. 1. Przekonania norweskich i polskich respondentów dotyczące podejmowania sztucznego odżywiania w zaawansowanej demencji oraz jego efektywności dla tej populacji chorych były znacząco różne. 2. Według większości respondentów prawo do podejmowania każdej decyzji dotyczącej rozpoczęcia sztucznego odżywiania ma jedynie lekarz. 3. Należy opracować ogólne wytyczne i standardy polityki żywieniowej w stosunku do chorych z zaawansowaną demencją, a także wyjaśnić częste nieporozumienia związane z domniemaną efektywnością sztucznego odżywiania w tej populacji pacjentów

Opinion of surveyed nurses on transplantation and reasons for negative public attitudes toward organ donation

Organ transplantation saves thousands of lives every year. Despite growing awareness of transplantation, the issue of obtaining organs for transplantation has been controversial for years. Hundreds of people are waiting in lines all the time for transplantation, for whom it is the only hope for a cure. One extremely important factor contributing to the low number of transplants is the low number of organ donations from deceased donors. Nurses are considered key facilitators of the organ procurement and transplantation process. Their knowledge of and attitudes toward organ donation can influence public opinion, as well as the decisions of their families to donate the organs of the deceased. The purpose of our study was to determine the opinions of surveyed nurses about transplantation and the reasons for negative public attitudes toward organ donation. The survey included 793 nurses employed in surgical wards across Poland with varying levels of job seniority. The survey was conducted between September and October 2022. The research tool was a survey questionnaire, consisting of three parts: socio-demographic data, questions assessing the respondents' knowledge of behavior about transplantation, and a non-standardized tool to measure respondents' emotional and motivational attitudes toward transplantation. Participation in the survey was anonymous and voluntary. The statistical analysis for independence of variables used the χ2 test. On the other hand, coefficients based on the Phi and Cramer's V test, as well as Kruskal Wallis non-parametric tests for assessing differences (for more than 2 samples) were used to determine the strength of the relationship. During these analyses, in addition to standard statistical significance, the corresponding “p” values were calculated using the Monte Carlo method. According to the nurses surveyed, transplantation is a life-saving procedure. A significant proportion of the nurses (85.6%) believe that there are too few donors in Poland. According to 41.8% of the respondents, this is due to the fear of misdiagnosis of death, for 23.4% it is incompatible with their worldview or religion and 31.8% believe it is due to the belief in the inviolability of the human body after death. The survey showed that, in the nurses' opinion, the reason for objections to organ transplantation is the deficit in public's knowledge of cell, tissue and organ donation from both living and dead donors. Therefore it is extremely important to conduct educational campaigns in this regard

Psychosocial Burden and Quality of Life of Surveyed Nurses during the SARS-CoV-2 Pandemic

This study analyzes the impact of occupational burnout on the quality of life (QOL) of nurses surveyed during the SARS-CoV-2 pandemic. A total of 668 active nurses employed in public hospitals in Podkarpackie voivodeship (Poland) were surveyed. Throughout the pandemic, all wards where responders worked had a division into so-called “clean” and “dirty” zones, as well as balanced working hours. The research used the authors’ survey questionnaire Maslach Burnout Inventory (MBI) and the Polish version of the World Health Organization Quality of Life Instrument Short Form (WHOQOL-BREF). Descriptive statistics were used in the analysis of the collected material, while correlations between ordinal or quantitative variables were made using Spearman’s-rho coefficient. According to 94.0% of respondents, stress is an integral part of the nursing profession. The mean of the respondents’ MBI burnout was 50.83 +/− 9.05 pts. The respondents’ overall quality of life also averaged 65.74 +/− 13.12 pts. There were negative statistically significant correlations between the MBI and BREF domains, most of which were characterized by clear strengths of association. Higher exhaustion in various occupational aspects is associated with poorer quality of life in individual domains