Zadovoljstvo pacijenata uslugama bolničke ishrane

Introduction: Satisfaction of patients has been frequently used as an indicator of quality in the healthcare sector. The analysis of patient satisfaction or experience in respect of hospital food is an important segment influencing the overall satisfaction with hospital services provided, and the study results should serve for the purpose of improving the service quality. Aim: To analyse patient satisfaction with hospital food services, evaluate the level of satisfaction in respect of food distribution, and give recommendations for improvement of hospital food quality. Materials and methods: The study included 300 patients hospitalized in the Clinical Centre of the University of Sarajevo (CCSU). The study used an anonymous, purposely designed questionnaire. The study was conducted in the period from 1 May to 31 August 2017. Results: The study related to patient satisfaction with hospital food services showed that the respondents were satisfied with hospital food in the majority of cases. Few respondents were unsatisfied with food provided from the central kitchen, specifically 5% of them; 25% of the respondents were unsatisfied with the nutritive value of the food, 6% of them were unsatisfied with the menu, and 10% of the respondents were unsatisfied with the dietary treatment. Conclusion: Nutrition of patients during their hospital treatment has significant influence on the overall recovery and it significantly affects the overall satisfaction regarding patients’ treatment in hospital. Small number of the tested patients showed subjective perception in respect of nutritive value of the food and prescribed dietary regime.Uvod: Zadovoljstvo pacijenata sve se više upotrebljava kao indikator kvalitete u zdravstvenom sektoru. Ispitivanje zadovoljstva ili iskustava pacijenata s prehranom u bolnici predstavlja važan segment koji utječe na opće zadovoljstvo pruženim zdravstvenim uslugama u bolnici, a rezultati ispitivanja moraju služiti u svrhu poboljšanja kvaliteta usluga. Cilj rada: Ispitati zadovoljstvo pacijenata uslugama bolničke prehrane, ocijeniti stupanj zadovoljstva distribucijom hrane te prikazati preporuke za unaprjeđenje kvalitete bolničke prehrane. Metode istraživanja: Istraživanje je provedeno među 300 hospitaliziranih pacijenata u Kliničkom centru Univerziteta u Sarajevu. Za istraživanje je primijenjen namjenski konstruiran anonimni anketni upitnik. Istraživanje je provedeno u periodu od 1. svibnja do 31. kolovoza 2017. Rezultati istraživanja: Naše je istraživanje pokazalo da su ispitanici u najvećem broju slučajeva zadovoljni bolničkom prehranom. Manji je broj ispitanika nezadovoljan hranom iz centralne kuhinje, i to 5%, 25% ispitanika nije zadovoljno nutritivnom vrijednošću obroka, 6% jelovnikom, a 10% provođenjem dijetetskog tretmana. Zaključak: Prehrana pacijenata za vrijeme bolničkog tretmana ima važan utjecaj na cjelokupni oporavak od bolesti i znatno utječe na opće zadovoljstvo pacijenta tretmanom u bolnici. Manji broj ispitanika subjektivno percipira nezadovoljstvo nutritivnom vrijednošću obroka i provođenjem propisane dijete

The department of construction management: A historical overview

Historical data are presented dating from the foundation of the Department of Construction Management, Faculty of Civil Engineering, University of Zagreb up to the present day. The work of the department is presented through teaching and scientific activities, international cooperation, publishing work, the organization of teaching for undergraduate, post-graduate and PhD studies, and work by scientists at international congresses and publication of articles

Application and development of information technology in the civil engineering sector in Croatia

Prikazuju se rezultati rada na dva znanstvena projekta o primjeni i razvoju informatičke tehnologije u hrvatskom graditeljstvu. Opisuju se istraživanja koja se nastavljaju na ona opisana u prethodno objavljenim radovima. Ovdje su prikazani rezultati ankete provedene u 2002., na koju se od 105 pozvanih tvrtki odazvalo 58. Istaknuto je da se u odnosu na prethodno razdoblje primjećuje napredak, ali da još nije stanje zadovoljavajuće te se daju prijedlozi za poboljšanje stanja.Results obtained on two research projects focusing on the use and development of information technology in construction industry in Croatia are presented. The research following that presented in previous papers is described. Results obtained during survey conducted in 2002, when 58 out of 105 companies responded to the survey, are presented. It is emphasized that, compared to the previous period, the situation has improved although it can still not be considered satisfactory. Proposals are given for making improvements in this field

Applying a Combined Chronometric- Simulation Method for Optimizing Operation Management in Construction

This paper describes a Croatian educational experience about the possibility of implementing a combination of the famous method of “work study” and the most modern simulation software to improve construction production. For the first time the students observed the capital technological construction processes “on site” and then measured the necessary time for their execution by the well known “chronometric” method. During the second exercise they analyzed the real observed processes and the sample of collected data. After that, they made a “graphic-simulation” model using the best-known software “Stroboscope” for simulating “just” the construction technological processes. At the end of their training exercise, the students concluded about the possibilities of improving technological construction processes on a “real site”. The main goal of this paper was to describe the “real process” of real education for some regular Croatian students. The simulation of construction processes, with real collection of data, may train the students about what to do in real situations. Of course, this paper presents only the general approach without greater detail

MENADŽMENT RIZIKA U PROCESU KLINIČKE ZDRAVSTVENE NJEGE

Risk management in the process of nursing clinical practice is a systematic process that requires expertise and skills in risk prevention. Patient safety at the hospital is the primary goal of every individual providing health care service, and at the same time of the organizations. Accordingly, it is necessary to develop strategies that minimize the risks in the hospital and successfully address adverse events in practice. The main hypothesis was that risk management in the healthcare process has a positive impact on the quality and safety of healthcare service. The following goals were set: 1) to identify the most common risks reported in the healthcare process; 2) to examine the ways and models of risk prevention in the healthcare process in hospitals; and 3) to examine the practice and attitude of nurses in the process of managing risks and adverse events. The survey was conducted among 115 nurses/medical technicians employed at the public health institutions-hospitals in the Federation of Bosnia and Herzegovina. The survey used the original questionnaire prepared by the authors in the electronic Google forms, which was available to the respondents via personal e-mail address, and they responded completely independently without the infl uence of another person. Comparison of risk events in practice showed a statistically signifi cant decrease with advancing age of the respondents (rho=-0.274; p=0.003), longer work experience of the respondents (rho=-0.334; p=0.0001), higher education of the respondents (rho=-0.198; p=0.034), conducting patient categorization (rho=-0.289; p=0.002), and policies and procedures adopted (rho=-0.408; p=0.0001). A statistically signifi cant effect on reducing the number of adverse events per patient was shown for the frequency of examination of patient skin and mucous membranes during hospital stay (rho=-0.200; p=0.032), use of scales to assess the risk of falls (rho=-0.422; p=0.0001), use of risk assessment scales for pressure ulcers (rho=-0.375; p=0.0001), frequency of intravenous cannula replacement (rho=-0.204; p=0.029), frequency of patient bathing (rho=-0.355; p= 0. 0001) and the method of performing nutritional evaluation of artifi cially fed patients (rho=-0.327; p=0.0001). In conclusion, patient safety in the hospital should be considered a paramount issue, and nurses who spend most time with patients are expected to provide conditions for secure hospital stay, conditions for safe and quality service in the health care process, and implementation of standardized procedures based on scientifi c and practical evidence. Continuous reporting of quality indicators in the health care process contributes to strengthening of the organizational culture, prevention of risks and adverse events, and planning of personnel and equipment necessary for the quality of the health care process.Upravljanje rizicima u procesu sestrinske kliničke prakse je sistematičan proces koji zahtijeva stručnost i vještine u prevenciji nastanka rizika. Sigurnost bolesnika u bolnici je primarni cilj svakog pojedinca koji pruža zdravstvenu uslugu, a istodobno i same organizacije. U skladu s time neophodno je razviti strategije kojima će rizici u bolnici biti svedeni na minimum i kojima će se uspješno riješiti neželjeni događaji u praksi. Glavna hipoteza rada bila je da upravljanje rizicima u procesu zdravstvene njege ima pozitivan utjecaj na kvalitetu i sigurnost zdravstvenih usluga. Ciljevi rada bili su: 1. Utvrditi najčešće rizike koji se prijavljuju u procesu zdravstvene njege; 2. Ispitati načine i modele prevencije rizika u procesu zdravstvene njege u bolnicama; 3. Ispitati praksu i stav medicinskih sestara u procesu upravljanja rizicima i neželjenim događajima. Istraživanje je provedeno među 115 medicinskih sestara-tehničara zaposlenih u javnim zdravstvenim ustanovama, bolnicama u FBiH. U istraživanju je primijenjen originalni autorski anketni upitnik pripremljen u elektroničkom programu Google forms koji je ispitanicima bio dostupan putem osobne adrese e-pošte, a na njega su odgovarali potpuno samostalno bez utjecaja druge osobe. Usporedba rizičnih događaja u praksi pokazuje statistički značajno smanjenje u odnosu na stariju dob ispitanika (rho=-0,274; p=0,003), duži radni staž ispitanika (rho=-0,334; p=0,0001), višu stručnu spremu ispitanika (rho=-0,198; p=0,034), provođenje kategorizacije bolesnika (ro=-0,289; p=0,002), usvojene politike i postupke (rho=-0,408; p=0,0001). Na smanjenje broja neželjenih događaja za bolesnika statistički značajan utjecaj pokazali su: učestalost pregleda kože i sluznica bolesnika za vrijeme hospitalizacije (rho=-0,200; p=0,032), uporaba ljestvica za procjenu rizika od pada (rho=-0,422; p=0,0001), uporaba ljestvica za procjenu rizika za nastanak dekubitusa (rho=-0,375; p=0,0001), učestalost promjene intravenske kanile (ro=-0,204; p=0,029), učestalost kupanja bolesnika (rho=-0,355; p=0,0001) i način nutritivne procjene bolesnika koji se hrane umjetnim putem (rho=-0,327; p=0,0001). U zaključku, sigurnost bolesnika u bolnici treba biti na prvom mjestu, a od medicinskih sestara koje najviše vremena provode uz bolesnike očekuje se osiguranje uvjeta za siguran smještaj u bolničkom prostoru, uvjeta za sigurnu i kvalitetnu uslugu u procesu zdravstvene njege te primjenu standardiziranih postupaka osnovanih na znanstvenim dokazima i dokazima iz prakse. Kontinuirano izvještavanje o indikatorima kvalitete u procesu zdravstvene njege doprinosi jačanju organizacijske kulture, prevenciji rizika i neželjenih događaja te planiranju kadrova i opreme neophodne za kvalitetu procesa zdravstvene njege

PRIMJENA MODELA KATEGORIZACIJE BOLESNIKA PREMA POTREBAMA ZA ZDRAVSTVENOM SKRBI KAO POKAZATELJ EFIKASNOSTI I EFEKTIVNOSTI SESTRINSKE KLINIČKE PRAKSE

Introduction: Evaluation and categorization of patients enable us to determine the number of hours required for their medical treatment, to calculate the number of required nursing staff, to monitor and evaluate results, and to determine financing of services. Standardized forms are used for appropriate assessment of patient condition and need for medical care. Categorization of patients contains comprehensive data related to patient condition based on 16 risk factors. Objective of the study: to determine the number of hospitalized patients categorized in the group of patients in high demand for progressive care; to show care evaluation and treatment outcome of highly categorized patients; and to examine the ratio of medical care providers in relation to the number of highly categorized patients. Methods: the study was conducted among patients hospitalized at the Sarajevo University Clinical Center in the period from January 1 to December 31, 2017. The research used standardized nursing documentation, patient categorization forms, monthly evaluation reports and other relevant documentation. The study included 25 organizational units. Analysis of highly categorized patients requiring progressive medical care was conducted in 15 organizational units of the Sarajevo University Clinical Center. In the course of the study, identity and other personal data of patients were protected. This was a retrospective study. Study results and discussion: patients were categorized in one of four categories, in accordance with the methodology described. Most of the total of 28097 patients were category 1 patients where self care sufficed (40.7%), while there were 22.4% of patients in category 4, the majority of them hospitalized at the Department of Neurology (n=1300). Based on the number of patients from different categories and the time required for their treatment, we gave an estimate of the number of nurses required for providing quality medical care. Their number was by 50% lower than their actual number. The percentage of cured patients at the Sarajevo University Clinical Center was 75%. Conclusions: categorization of patients should have its purpose and final objective directed at strategic planning of human resource in the field of nursing, monitoring the course and outcome of health care processes, and analysis of nursing clinical practice efficiency and effectiveness. Study results showed realistic need for medical care providers at different departments where patients were categorized for progressive care. Analysis of the results confirmed that the percentage of cured patients was higher at departments with a higher number of nurses in respect to their estimated number.Uvod: Procjena trijažiranja bolesnika u kategorije omogućava nam utvrditi broj sati potrebnih za zdravstvenu skrb bolesnika, proračun potrebnog sestrinskog osoblja, praćenje i evaluiranje ishoda i financiranje usluga. Za odgovarajuću procjenu stanja bolesnika i potreba za zdravstvenom skrbi koriste se standardizirani obrasci. Kategorizacija bolesnika sadrži sveobuhvatne podatke o stanju bolesnika sagledanom u 16 čimbenika rizika u zdravstvenoj njezi. Cilj rada: Utvrditi broj hospitaliziranih bolesnika kategoriziranih visokom ocjenom za progresivnu zdravstvenu skrb; prikazati evaluaciju zdravstvene skrbi i ishod liječenja visoko kategoriziranih bolesnika; ispitati omjer izvršitelja zdravstvene skrbi u odnosu na broj visoko kategoriziranih bolesnika. Metode: Istraživanje je provedeno među hospitaliziranim bolesnicima u Kliničkom centru Sveučilišta u Sarajevu od 1. siječnja do 31. prosinca 2017. godine. Za istraživanje je korištena standardizirana sestrinska dokumentacija, obrasci kategorizacije bolesnika, mjesečna izvješća i druga relevantna dokumentacija. Istraživanje je provedeno u 25 organizacijskih jedinica ustanove. Analizirani su visoko kategorizirani bolesnici za potrebe progresivne zdravstvene skrbi u 15 organizacijskih jedinica Kliničkoga centra Sveučilišta u Sarajevu. Za vrijeme provođenja istraživanja identitet i drugi osobni podatci o bolesnicima bili su zaštićeni. Istraživanje je retrospektivno. Rezultati i rasprava: Bolesnici su svrstani u jednu od četiri kategorije sukladno metodi opisanoj u radu. Od 28.097 bolesnika najviše ih je bilo 1. kategorije za koje je samoskrb dovoljna (40,7%), dok je bolesnika 4. kategorije bilo 22,4%, od čega najviše u Neurološkoj klinici (1300). Na osnovi broja bolesnika različitih kategorija i vremena koje je potrebno za njihovo liječenje procijenjen je broj medicinskih sestara neophodan za kvalitetnu skrb. Njihov broj je za 50% manji od stvarnog broja zaposlenih. Postotak izliječenih bolesnika u Kliničkom centru Univerziteta u Sarajevu je 75%. Zaključci: Razvrstavanje bolesnika u kategorije trebalo bi imati svoju svrhu i konačan cilj usmjeren na strateško planiranje ljudskih resursa u području sestrinstva, praćenje tijeka i ishoda procesa zdravstvene skrbi te analizu učinkovitosti i sposobnosti sestrinske kliničke prakse. Rezultati istraživanja pokazali su stvarne potrebe za izvršiteljima zdravstvene skrbi na odjelima klinika gdje su bolesnici kategorizirani ocjenom za progresivnu skrb. Analizom rezultata je potvrđeno da je postotak izliječenosti veći na klinikama koje imaju broj sestara veći u odnosu na procijenjeni

Information technology in Croatia\u27s construction industry

Prikazani su zbirni rezultati istraživanja za znanstveni projekt “Razvoj primjene informatičke tehnologije u hrvatskom graditeljstvu”. Rezultati se temelje na obrađenim podacima iz dobivenih odgovora na pitanja postavljena u anketnom ispitivanju glavnih menadžera iz 49 graditeljskih tvrtki. Autori ističu bitne razloge zaostajanja hrvatskog graditeljstva u primjeni suvremene informatičke tehnologije u odnosu na razvijeni svijet i predlažu smjernice za njezin učinkovitiji razvoj.Summarized results as obtained in the scope of the research project called "Developments in the use of information technology in Croatia\u27s construction industry", are presented. The results are based on the analysis of answers obtained during survey involving general managers from 49 construction companies. Authors present main reasons why Croatia\u27s construction industry is lagging behind developed countries in the use of modern information technology, and provide guidelines aimed at fostering more efficient advances in this field