KNOWLEDGE OF NURSES/TECHNICIANS ON THE TREATMENT OF CHRONIC WOUNDS IN RELATION TO THE LEVEL OF HEALTHCARE

It is estimated that 1 to 2% of the population in developed countries will experience a chronic wound during their lifetime. Nurses are leaders in applying innovations that can create positive results in preventing and treating chronic wounds in patients admitted to acute care hospitals. The aim of the research is to examine the knowledge of nurses-technicians about the knowledge of measures for the prevention and treatment of chronic wounds. In the research of knowledge on the treatment of chronic wounds, 349 respondents participated, employed at the primary and tertiary levels of health care. For the purposes of the research, the authors created a questionnaire based on a review of professional and scientific literature, as well as evidence in practice. The research was conducted through the Chamber of Nurses-Technicians of Sarajevo Canton and the Chamber of Tuzla Canton. Respondents from Sarajevo Canton worked significantly longer in practice, and 36.2% of respondents worked from 21 to 30 years, and 10.9% of respondents worked longer than 30 years, while among respondents from Tuzla Canton 34.8% of them, worked from 21 to 30 years and 9.9% worked for more than 30 years. 43.9% of respondents from Tuzla Canton and 39.6% of respondents from Sarajevo Canton had a certificate for the care of chronic wounds (X 2 = 9.077; p = 0.028). The assessment of knowledge is in a direct positive relationship with the level of health care (rho = 0.187; p = 0.001). Analysis of the knowledge in relation to the level of health care showed that respondents employed at the tertiary level of health care, have significantly better knowledge about the treatment of chronic wounds. We conclude that the assessment of knowledge is in a direct positive relationship with the level of health care

KNOWLEDGE OF NURSES/TECHNICIANS ON THE TREATMENT OF CHRONIC WOUNDS IN RELATION TO THE LEVEL OF HEALTHCARE

It is estimated that 1 to 2% of the population in developed countries will experience a chronic wound during their lifetime. Nurses are leaders in applying innovations that can create positive results in preventing and treating chronic wounds in patients admitted to acute care hospitals. The aim of the research is to examine the knowledge of nurses-technicians about the knowledge of measures for the prevention and treatment of chronic wounds. In the research of knowledge on the treatment of chronic wounds, 349 respondents participated, employed at the primary and tertiary levels of health care. For the purposes of the research, the authors created a questionnaire based on a review of professional and scientific literature, as well as evidence in practice. The research was conducted through the Chamber of Nurses-Technicians of Sarajevo Canton and the Chamber of Tuzla Canton. Respondents from Sarajevo Canton worked significantly longer in practice, and 36.2% of respondents worked from 21 to 30 years, and 10.9% of respondents worked longer than 30 years, while among respondents from Tuzla Canton 34.8% of them, worked from 21 to 30 years and 9.9% worked for more than 30 years. 43.9% of respondents from Tuzla Canton and 39.6% of respondents from Sarajevo Canton had a certificate for the care of chronic wounds (X 2 = 9.077; p = 0.028). The assessment of knowledge is in a direct positive relationship with the level of health care (rho = 0.187; p = 0.001). Analysis of the knowledge in relation to the level of health care showed that respondents employed at the tertiary level of health care, have significantly better knowledge about the treatment of chronic wounds. We conclude that the assessment of knowledge is in a direct positive relationship with the level of health care

Injury severity scoring protocols as predictors of outcome for polytrauma patients

Uvod: Težina ozljede kod politrauma procjenjuje se na temelju ljestvica koje se koriste zbrojem bodova (numerički sustavi), činjenica ozljede kao i na temelju iskustva u procjeni težine ozljeda. Skraćena ljestvica ozljeda (eng. Abbreviated Injury Scale - AIS) rangira ozljede od 1 do 6, s tim da 1 označava lakše ozljede, a 6 maksimalno teške ozljede. Ljestvica nije dizajnirana za predviđanje preživljavanja i koristi se rezultatima koji se temelje na konsenzusu. Ocjena ozbiljnosti ozljede (eng. Injury Severity Score - ISS) dodjeljuje bodove ozljedama traumatiziranog pacijenta s višestrukim ozljedama cijelog tijela. Cilj je ovog rada odrediti prediktivne vrijednosti postojeće ljestvice ozljeda na ISS ljestvici. Metode: Uzorak je obuhvatio 84 pacijenta oba spola i svih dobnih skupina koji su praćeni tijekom jedne godine. Ispitanici su imali višestruke, prodorne i nepenetrantne ozljede, a uključivali su i one čiji su vitalni parametri stabilizirani te je dijagnostika provedena prema protokolu u Klinici za intenzivnu njegu bez obzira na konačni ishod. Primijenjena je formula koja se koristi za pretvaranje AIS-a u ISS rezultat protokola gradacije. Rezultati: Ispitanici su bili prosječno u dobi od 40 ± 17,6 godina, od kojih je većina bila muškaraca, a prometne su nesreće bile prevladavajući mehanizam ozljeđivanja. ISS se povećava s težinom ozljeda. Udio pacijenata s CCC bodom ≤ 14 imao je pozitivnu prediktivnu vrijednost različitu od ISS-a. Udio ispitanika s politraumom koji su imali CCC rezultat = 15 i ISS < 15 imao je negativnu prediktivnu vrijednost. Zaključak: Utvrđeno je da postoji razlika u pouzdanosti između CCC-a i ISS sustava u određivanju stupnja ozbiljnosti stanja u bolesnika liječenih u Klinici za intenzivnu njegu.Introduction: The severity of the injury is assessed against many scales, which use a sum of scores (numerical systems), injury facts, and experience to assess the severity of injuries. The AIS (Abbreviated Injury Scale) ranks injuries from 1 to 6, 1 being minor injuries and 6 being maximal injuries. It is not designed to predict survival and uses consensus-based scores determined by experts. The Injury Severity Score (ISS) assigns scores to the injuries of a trauma patient with whole-body multiple injuries. This paper aims to determine the predictive values of the existing scale of injuries on the ISS scale. Methods: The sample included 84 patients of both sexes and from all age groups, who were monitored over one year. The subjects had multiple penetrating and non-penetrating injuries, and included those whose vital parameters were stabilized and whose diagnostics were conducted according to the protocol in the Emergency Medicine Clinic regardless of the outcome. The formula used to convert AIS to ISS gradation protocol score was applied. Results: The subjects were aged 40 ± 17.6 years on average, most of whom male; road accidents were the predominant mechanism of injury. The ISS increases with the severity of injuries. The proportion of patients with a CCC score ≤14 had a positive predictive value different from the ISS. The proportion of subjects with polytrauma who had a CCC score = 15 and an ISS <15 had a negative predictive value. Conclusion: It was found that there was a difference in reliability between the CCC and ISS systems in determining the levels of severity of conditions in patients treated at the Critical Care Clinic

BIOETIČKO ODLUČIVANJE U KLINIČKOJ SESTRINSKOJ PRAKSI

Introduction: Nursing as a profession and vocation is understood as humanity, altruism and dedication. Nurses possess 4 types of responsibilities: human, legal, ethical and professional, within which protective models are oriented to the well-being of the patient. The values, rules and principles within nursing practice are regulated by codes of ethics. Aim: To determine the infl uence of knowledge, positive attitude and love for the profession, as well as practices based on high moral and ethical principles in graduate nurses on making ethical decisions in work with patients. Material and methods: The study was conducted among 106 graduate nurses of the Clinical Center of the University of Sarajevo. The study was descriptive, transverse according to the cross-sectional type. The study was conducted in the period from June 1, 2019 to September 30, 2019. Statistical data processing was performed using the χ2-test, Fisher test, Mann-Whitney U test, and other tests. Results: The majority of respondents (89.4%) stated that they chose nursing profession out of love and desire to help sick people. The largest number of respondents make ethical decisions independently in the implementation of appropriate health care (84%), 62.3% are considered religious, but 77.7% of them believe that religiosity does not affect ethical decision making. Half of the respondents stated that they were in a situation to act as a legal protector for patients in case they noticed that they could be harmed. The majority of respondents (84%) did not have a situation to make wrong ethical decision in their practice. Conclusion: Our study confi rms that in order to make ethical decisions in working with patients, graduate nurses must have quality knowledge, a positive attitude and love for the profession, and a practice based on high moral and ethical principles.Uvod: Sestrinstvo kao profesija i poziv shvaćeno je kao humanost, altruizam i predanost. Medicinske sestre imaju 4 vrste odgovornosti i to: ljudska, pravna, etička i profesionalna, a unutar kojih se prožimaju zaštitnički modeli usmjereni na dobro bolesnika. Vrijednosti, pravila i načela unutar sestrinske prakse regulirani su etičkim kodeksima. Cilj: Utvrditi utjecaj znanja, pozitivno izgrađenog stava i ljubavi prema struci, kao i prakse zasnovane na visokim moralnim i etičkim načelima kod diplomiranih medicinskih sestara na donošenje etičkih odluka u radu s bolesnicima. Materijal i metode: Istraživanje je provedeno među 106 diplomiranih medicinskih sestara Kliničkog centra Univerziteta u Sarajevu. Istraživanje je deskriptivno, transverzalno prema tipu poprečne (cross-sectional) studije. Istraživanje je provedeno u razdoblju od 1. lipnja 2019. do 30. rujna 2019. godine. Statistička obrada podataka učinjena je uz primjenu χ²-testa, Fisherova testa, Mann-Whitneyeva U testa i drugih testova. Rezultati: Većina ispitanika (89,4 %) izjavila je da su sestrinsku struku odabrali iz ljubavi i želje da pomažu bolesnim osobama. Najveći broj ispitanika samostalno donosi etičke odluke kod provođenja odgovarajuće zdravstvene njege (84 %), 62,3 % se smatra religioznim, međutim 77,7 % ih smatra da religioznost ne utječe na donošenje etičkih odluka. Polovina ispitanih navodi kako su bili u situaciji da se ponašaju kao pravni zaštitnik bolesnika kada primijete da bi im se mogla nanijeti šteta. Većina ispitanika (84 %) nije bila u situaciji da u svojoj praksi donesu pogrešnu etičku odluku. Zaključak: Rad potvrđuje da za donošenje etičkih odluka u radu s bolesnicima diplomirane medicinske sestre moraju imati kvalitetno znanje, izgrađen pozitivan stav i ljubav prema struci te praksu zasnovanu na visokim moralnim i etičkim načelima

Neurološke komplikacije vodenih kozica: prikaz serije bolesnika i pregled literature

Chickenpox, as a self-limited disease, can result with a large spectrum of complications. Neurological complications are very rare, and among them acute cerebellar ataxia is the most frequent one. Also, varicella-zoster virus has been reported as the second infectious agent of acute encephalitis. We present neurological complications of chickenpox in a five year period of hospitalisation in the Infectious Diseases Clinic, Clinical Centre at the University of Sarajevo, Bosnia and Herzegovina. Among 181 hospitalised patients, nine had neurological complications. Acute cerebellitis was the most frequent diagnosis. All patients were treated with acyclovir, and the outcome was a major success.Vodene kozice, kao samoograničavajuća bolest, može rezultirati velikim rasponom komplikacija. Neurološke komplikacije iznimno su rijetke, a među njima je akutna cerebelarna ataksija. Također, varicella-zoster virus naveden je kao drugi zarazni uzročnik akutnog encefalitisa. Predstavljamo neurološke komplikacije virusa u petogodišnjem razdoblju hospitalizacije u Klinici za zarazne bolesti Kliničkog centra Sveučilišta u Sarajevu, Bosna i Hercegovina. Među 181 hospitaliziranih pacijenata, njih devet imalo je neurološke komplikacije. Akutni cerebelitis bio je najčešća dijagnoza. Svi bolesnici su liječeni aciklovirom, što je rezultiralo ogromnim uspjehom

Quality of life of mothers who have children with developmental disabilities

Introduction: The primary source of strength and support is the child’s family. A special role in caring for a child with developmental disabilities is played by his mother. The objective of this research is to find out the assessment of the quality of life (QOL) of disabled children mothers as well as to research the relation of sociodemographic variables of the respondents, as specified in this study and estimate the quality of their life and health.Methods: The cross-sectional study was performed by the use of the descriptive-analytical method. In a targeted association of families which have children and persons with difficulties was conducted this research on a sample of 100 registered mothers. The research instrument was the standardized questionnaire for QOL, the World Health Organization QOL-BREF and the users’ records of the mothers in the association.Results: The average age of the respondents was M = 48. 01 ± 11. 68. About 62% of the respondents are married, 54% have a high school diploma, 67% are not employed, 68% of the respondents did not declare to have health problems, and among those who declared to have health problems, the most common disease was diabetes mellitus. The average number of household members was M = 3. 44 members. The number of the household members was significantly and positively related to the domain of social interaction (rs = 0. 219; p &lt; 0. 05), the domain of the environment (rs = 0. 220; p &lt; 0. 05) and to the general QOL (rs = 0. 227; p &lt; 0. 05). The age of the respondents was significantly and positivelyrelated only to the environmental domain (rs = 0. 205; p &lt; 0. 05). The respondents who drive a car showed a significantly higher level of QOL in the field of mental health (p = 0. 042) and the environment (p = 0. 005). Concerning mothers with higher incomes rate, their QOL was better in the following domains: Physical health (p = 0. 030), mental health (p = 0. 002), environment (p = 0. 000001), and general QOL (p = 0. 0002).Conclusion: The respondents with a larger number of household members, those who have the support of family members, who were without health problems, and who independently use own car for transportation, consider their QOL as being better. Therefore, a promotional – preventive program for improving the life quality of mothers of children and persons with disabilities should include accessible life in the community and the ability to recognize the unique needs of the entire family of children and persons with disabilities

Daily activities of employed persons with visual impairment

Introduction: The challenges faced by visually impaired people in their efforts to integrate themselves into the labor market and the general position of persons with disabilities, regarding their employment and social security, is extremely difficult. Employment is the best safeguard against social exclusion and one of the main ways to achieve a full involvement in the society of the visually impaired people.Methods: The research was conducted on a sample of 25 visually impaired people employed at “TMP” d.o.o. Sarajevo. The study was used as a cross-sectional survey method wherein data were collected through appropriate survey instruments, using a modified survey questionnaire.Results: Out of the total number of respondents, 48% are male and 52% are female. The majority of respondents use other persons’ assistance when moving (n = 16). The largest number of respondents had 100% visual impairment (n = 17). The majority of subjects have no strenuous physical activity. The largest number of respondents during the previous week walked for at least 10 minutes, in the sequence of all 7 days and was driven in motor vehicles. When doing household chores, 56% of respondents said they had no difficulty. The most common difficulties in recreation, sports and physical activity in leisure time, that were encountered by 32% of respondents, are poor sound signalling and difficulties of visual nature, though 68% of respondents said that they had no difficulty in their recreational activities.Conclusion: The daily activities of employed visually impaired persons have a positive impact on their quality of life. Various are occupations of visually impaired people that improve their quality of life

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 &lt; 0.001), as well as in the safety climate at work in relation to the workplace (p = 0.005), working conditions (p &lt; 0.001), and management perception (p &lt; 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

Perfusion magnetic resonance neuroimaging

The clinical appliance of perfusion is being continuously developed and it is closely related to technology development. The role of perfusion neuroimaging in the management of acute stroke has been to prove reduced regional blood flow and to give the contribution in the identification of ischemic areas, respectively the regions of hypoperfusion that can be treated by thrombolytic and/or endovascular recanalization therapy. There are two main approaches to the measurement of cerebral perfusion by magnetic resonance. The aim of this article is to compare different measuring approaches of MR perfusion neuroimaging