Nurses' job satisfaction in KBC Zagreb and KB Merkur

Cilj: ciljevi ovog istraživanja su ispitati zadovoljstvo poslom s obzirom na godine radnog iskustva, dob, stručnu spremu i radna mjesta kod medicinskih sestara i medicinskih tehničara u obje bolnice, ispitati zadovoljstvo mogućnostima napredovanja u ispitanika u obje bolnice, utvrditi povezanost zadovoljstva poslom s nadređenima na radnome mjestu u obje bolnice. Nacrt studije: provedeno je presječno istraživanje u KBC-u Zagreb i KB-u Merkur. Ispitanici i metode: istraživanje je provedeno na 132 ispitanika, od kojih je 89 (67,4 %) zaposleno u KBC-u Zagreb, a 43 (32,6 %) u KB-u Merkur. Iz obje bolnice zastupljeni su ispitanici s kirurških odjela. Kao instrument istraživanja korišten je standardiziran (valjani i pouzdani) upitnik, namijenjen ispitivanju generalnog stava i područja zadovoljstva poslom. Rezultati: u ukupnoj skali zadovoljstva, značajno su zadovoljniji ispitanici s najkraćim radnim stažem, dok su oni s duljim radnim stažem značajno nezadovoljniji. Ukupno zadovoljstvo je značajno veće kod ispitanika iz KBC-a Zagreb, medijana 117 (interkvartilnog raspona od 107,5 do 125) (Mann-Whitneyev U-test, P = 0,007). Ocjena cijele skale zadovoljstva pokazala je da su 43 (33 %) ispitanika nezadovoljna, njih 82 (62 %) nije ni nezadovoljno ni zadovoljno, dok je samo 7 (5 %) ispitanika zadovoljno na poslu. Zaključak: istraživanje je pokazalo da je samo 5 % medicinskih sestara/tehničara zadovoljno na poslu. Većina ispitanika smatra da ne napreduju jednako brzo kao i u drugim zanimanjima, većina nije zadovoljna svojim mogućnostima napredovanja.Purpose: the objectives of this study were to analyse job satisfaction concerning years of work experience, age, qualifications and workplace amongst nurses and medical technicians in both hospitals, to analyse the satisfaction with advancement opportunities amongst the respondents in both hospitals, as well as to establish the correlation between job satisfaction and the superiors at workplace in both hospitals. Study design: a cross-sectional survey was conducted at the University Hospital Centre Zagreb and the University Hospital Merkur. Respondents and methods: the survey was conducted on 132 respondents, of whom 89 (67.4%) were employed at the University Hospital Centre Zagreb and 43 (32.6%) at the University Hospital Merkur. The respondents from both hospitals were employed at the Departments of Surgery. A questionnaire-scale was used as a research instrument to determine the general attitude and job satisfaction. Results: on the overall satisfaction scale, the respondents with the shortest work experience were significantly more satisfied, while those with longer work experience were significantly more dissatisfied. Overall satisfaction was significantly higher amongst the respondents from the University Hospital Centre Zagreb, the median stood at 117 (interquartile range from 107.5 to 125) (Mann Whitney U test, P = 0.007). The overall satisfaction score showed that 43 (33%) of the respondents were dissatisfied, 82 (62%) were either dissatisfied or satisfied, while only 7 (5%) respondents showed job satisfaction. Conclusion: the research study has shown that only 5% of nurses/medical technicians showed job satisfaction. Most respondents believed that they were not advancing as fast as in other professions and most of them were not satisfied with their career advancement opportunities

Bioethical and social dilemmas in palliative care during the COVID-19 pandemic

Pandemija uzrokovana koronavirusom, SARS-CoV-2/ COVID-19 globalno je rasprostranjena infektivna bolest koja je potaknula visoku stopu mortaliteta u cijelome svijetu. Osim mortaliteta i morbiditeta, pojavljuju se i određene bioetičke dileme, poput: procjene trijaže bolesnika zbog nemogućnosti zbrinjavanja terminalnih bolesnika u jedinicama intenzivnog liječenja te nespecificirano donošenje odluka vezanih uz njihovo održavanje i skrb na kraju života. Pandemija je potaknula i uskraćenost socijalnih relacija zabranom posjeta članova obitelji, što rezultira izoliranošću i prepuštenošću oboljelih samima sebi te ukazuje na nužnost intenzivnijeg angažmana mobilnih palijativnih timova u pružanju holističke skrbi integrativnog tretmana, palijativne skrbi.The pandemic, provoked by coronavirus, SARS-CoV-2 / COVID-19 is a globally spread infectious disease that has triggered high mortality rates worldwide. In addition to mortality and morbidity, certain bioethical dilemmas also arise: patient triage assessments due to the inability to care for terminal patients in intensive care units and unspecified decision-making related to their maintenance and end-of-life care. The pandemic also induced the denial of social relations by banning family members from visiting, resulting in isolation and self-indulgence of the patients to themselves, indicating the need for more intensive involvement of mobile palliative care teams in providing holistic care for integrative treatment of palliative care

Patient hospital discharge planning

Uvod: Planiranje otpusta pacijenta iz bolnice sastavni je dio skrbi o pacijentu. Procesi planiranja otpusta započinju odmah po primitku u bolnicu za one pacijente za koje se procijeni da će trebati nastavak skrbi. Cilj je ovog rada pomoću dostupne literature o planiranju otpusta pacijenata istaknuti važnost planiranja otpusta te ukazati na sigurnosne rizike povezane s planiranjem otpusta. Metode: U prosincu 2021. godine proveden je pregled stručne i znanstvene literature u bazama podataka MEDLINE/PubMed i Hrčak. Pregledani su zakonski propisi koji se odnose na zdravstvenu i socijalnu skrb te akreditacijski standardi za bolnice. Rezultati: Pretragom dostupne literature vidljivo je da planiranje otpusta pacijenta iz bolnice utječe na kvalitetu nastavka skrbi, na sigurnost pacijenta nakon otpusta iz bolnice, zadovoljstvo pacijenata i njihovih obitelji, na neplanirani povratak u bolnicu te pozitivno utječe na vrijeme boravka u bolnici. Zaključak: Planiranjem otpusta pacijenta iz bolnice osiguravamo kvalitetu nastavka skrbi, bilo da se pacijent otpušta kući ili je nastavak skrbi predviđen u nekoj od zdravstvenih ili socijalnih ustanova. Upravo zato, planiranju otpusta pacijenta treba pristupiti kao bitnoj metodi zdravstvene skrbi koja izravno utječe na sigurnost pacijenata i na kontinuitet skrbi po izlasku iz bolnice.Introduction: Patient discharge planning is an integral part of patient care. The discharge process begins immediately upon admission to the hospital for patients who are assessed as needing continuous care. The aim of this paper is to search available literature on patient discharge planning to emphasize the importance of discharge planning and to point out the security risks that may arise in this process. Methods: In December 2021, a review of professional and scientific literature in the databases MEDLINE/PubMed and Hrčak was conducted. Legal documents related to health and social care and accreditation standards for hospitals were also reviewed. Results: A review of the available literature shows that patient discharge planning affects the quality of continuous care, patient safety after hospital discharge, the satisfaction of patients and their families, readmission, and positively affects hospital length of stay. Conclusion: With patient discharge planning, we are ensuring quality in the continuity of care, whether the patient is discharged home or care is provided in one of the health or social institutions. Precisely for this reason, patient discharge planning should be approached as an important healthcare method that directly affects patient safety and continuous care after hospital discharge

Nursing Care for Patients Using VAC Therapy

Terapija negativnim tlakom (Vacuum Assisted Closure) je metoda liječenja rana koja se praktično primjenjuje u klinikama diljem svijeta, a počeci joj se naziru još u 1995. godini. VAC sustav osobito je učinkovit u liječenju traumatskih i kroničnih rana. Uspjeh liječenja VAC terapijom ovisi o nekoliko čimbenika, od kojih su najznačajniji dobra kirurška tehnika, pravilna procjena stanja bolesnika, te planiranje i provođenje postupka s pozitivnom evaluacijom na kraju liječenja. Postupci medicinske sestre kod postavljanja VAC aparata usmjereni su na psihofizičko stanje pacijenta, procjenu kože prije i nakon primjene VAC terapije, procjenu okolnog tkiva, procjenu položaja bolesnika u krevetu, procjenu i prilagodbu mikroklimatskih uvjeta te procjenu prisutnosti rizika od krvarenja. Veoma je važna edukacija bolesnika. Cilj članka je opisati postupak liječenja kronične rane VAC terapijom te pobliže objasniti zadaće medicinske sestre tijekom VAC terapije. Medicinska sestra mora posjedovati specifična znanja radi provođenja postupka, mora biti educirana u pružanju zdravstvene njege bolesniku s kroničnom ranom te podrška i oslonac bolesniku. VAC metoda je siguran i uspješan način liječenja, a s obzirom na to da je ekonomski povoljna za zdravstveni sustav i bolesnike, sve je češće metoda izbora u liječenju bolesnika s kroničnim ranama.Negative Pressure Therapy – Vacuum Assisted Closure – is a wound treatment method used in clinical practice throughout the world. Its beginnings date back to the year 1995. The VAC system is particularly effective in treatment of traumatic and chronic wounds. The success of VAC therapy treatment depends on several factors, the most important of which are a good surgical technique, proper assessment of the patient’s condition, and planning and conducting procedure, which are positively evaluated at the end of the treatment. Nurse’s interventions are focused on assessment of the patient’s psychophysical condition, skin condition assessment before and after the treatment, assessment of the skin surrounding the wound, proper body position during the procedure, assessment and adjustment of microclimate conditions, as well as bleeding risk estimate. Education of the patient must be accentuated as the most important intervention. The objective of this article is to describe the procedure of chronic wound treatment using VAC system and to explain the tasks of nurses in the course of VAC therapy. Nurses need to possess specific knowledge for the purpose of conducting the procedure, they need to be educated in providing the patient’s health care, and they need to provide support both to the patient and their family. VAC method is a safe and successful treatment method and since it is economically affordable both for the healthcare system and the patients, it is increasingly frequently selected for the treatment of patients with chronic wounds

A Partner Relationship in Meeting the Needs of Patients and Their Families

A nurse is the first person who comes in contact with patients and their family members. She shares information with them by verbal and non-verbal communication, with the goal of establishing a good relationship and focusing her attention on the patient as a whole person. Nurse’s sincere thoughts and feelings create a sense of security and open communication, which are key elements for providing healthcare and inclusion of the family in the decision-making process. A nurse who spends her time by the patient’s side plans, implements, evaluates and documents the changes in the patient’s condition. That way the healthcare is focused on meeting the physiological needs and maintaining stable condition of the patient. Struggle for life doesn’t leave any time for the family to adjust to the new situation. Establishing the patient – family – nurse relationship is important not only in the beginning, but also during the whole treatment and decision-making process. When relationships within the family are stable, the family has an irreplaceable role in developing a sense of security and belonging for the patient. Providing care for the patient is a priority for the healthcare team, whereas the most significant thing for the family are sincere and correct information about the patient’s current condition, the effect of the applied therapy and the possible outcome of the treatment. Developing care philosophy focused on the family and the holistic approach includes assessment of the family’s needs and the impact of the disease on its overall functioning. Cultural factors play a significant role in the ability to understand not only the patient’s but also the family’s point of view. Medical, ethical, legal and a whole range of other problems connected to the receiver and provider of services can be avoided by effective communication. The purpose of this paper is to highlight the importance of a partner relationship, focusing on the family and the essential role of the nurse in decision-making

Usporedba zadovoljstva poslom medicinskih sestara/tehničara u Kliničkom bolničkom centru Zagreb i Kliničkoj bolnici Merkur Nurses job satisfaction in Clinical Hospital Center Zagreb and Clinical Hospital Merkur

Uvod: Zadovoljstvo poslom važan je čimbenik u pružanju zdravstvene skrbi. Snažan empirijski dokaz podupire kauzalni odnos između zadovoljstva poslom, sigurnosti bolesnika i kvalitetne njege. Cilj: ciljevi ovog istraživanja su prikazati zadovoljstvo poslom s obzirom na godine radnog iskustva, dob, stručnu spremu i radna mjesta kod medicinskih sestara i medicinskih tehničara, ispitati zadovoljstvo mogućnostima napredovanja u ispitanika, utvrditi povezanost zadovoljstva poslom s nadređenima na radnome mjestu u obje bolnice. Nacrt studije: provedeno je presječno istraživanje u KBC-u Zagreb i KB-u Merkur. Ispitanici i metode: istraživanje je provedeno na 132 ispitanika, od kojih je 89 (67,4 %) zaposleno u KBC-u Zagreb, a 43 (32,6 %) u KB-u Merkur. Iz obje bolnice zastupljeni su ispitanici s kirurških odjela. Kao instrument istraživanja korišten je standardiziran (valjani i pouzdani) upitnik, namijenjen ispitivanju generalnog stava i područja zadovoljstva poslom. Rezultati: u ukupnoj skali zadovoljstva, značajno su zadovoljniji ispitanici s najkraćim radnim stažem, dok su oni s duljim radnim stažem značajno nezadovoljniji. Ukupno zadovoljstvo je značajno veće kod ispitanika iz KBC-a Zagreb, medijana 117 (interkvartilnog raspona od 107,5 do 125) (Mann-Whitneyev Utest, P = 0,007). Ocjena cijele skale zadovoljstva pokazala je da su 43 (33 %) ispitanika nezadovoljna, njih 82 (62 %) nije ni nezadovoljno ni zadovoljno, dok je samo 7 (5 %) ispitanika zadovoljno na poslu. Zaključak: istraživanje je pokazalo da je samo 5 % medicinskih sestara/tehničara zadovoljno na poslu. Većina ispitanika smatra da ne napreduju jednako brzo kao i u drugim zanimanjima, većina nije zadovoljna svojim mogućnostima napredovanja

Nurses' job satisfaction in KBC Zagreb and KB Merkur

Cilj: ciljevi ovog istraživanja su ispitati zadovoljstvo poslom s obzirom na godine radnog iskustva, dob, stručnu spremu i radna mjesta kod medicinskih sestara i medicinskih tehničara u obje bolnice, ispitati zadovoljstvo mogućnostima napredovanja u ispitanika u obje bolnice, utvrditi povezanost zadovoljstva poslom s nadređenima na radnome mjestu u obje bolnice. Nacrt studije: provedeno je presječno istraživanje u KBC-u Zagreb i KB-u Merkur. Ispitanici i metode: istraživanje je provedeno na 132 ispitanika, od kojih je 89 (67,4 %) zaposleno u KBC-u Zagreb, a 43 (32,6 %) u KB-u Merkur. Iz obje bolnice zastupljeni su ispitanici s kirurških odjela. Kao instrument istraživanja korišten je standardiziran (valjani i pouzdani) upitnik, namijenjen ispitivanju generalnog stava i područja zadovoljstva poslom. Rezultati: u ukupnoj skali zadovoljstva, značajno su zadovoljniji ispitanici s najkraćim radnim stažem, dok su oni s duljim radnim stažem značajno nezadovoljniji. Ukupno zadovoljstvo je značajno veće kod ispitanika iz KBC-a Zagreb, medijana 117 (interkvartilnog raspona od 107,5 do 125) (Mann-Whitneyev U-test, P = 0,007). Ocjena cijele skale zadovoljstva pokazala je da su 43 (33 %) ispitanika nezadovoljna, njih 82 (62 %) nije ni nezadovoljno ni zadovoljno, dok je samo 7 (5 %) ispitanika zadovoljno na poslu. Zaključak: istraživanje je pokazalo da je samo 5 % medicinskih sestara/tehničara zadovoljno na poslu. Većina ispitanika smatra da ne napreduju jednako brzo kao i u drugim zanimanjima, većina nije zadovoljna svojim mogućnostima napredovanja.Purpose: the objectives of this study were to analyse job satisfaction concerning years of work experience, age, qualifications and workplace amongst nurses and medical technicians in both hospitals, to analyse the satisfaction with advancement opportunities amongst the respondents in both hospitals, as well as to establish the correlation between job satisfaction and the superiors at workplace in both hospitals. Study design: a cross-sectional survey was conducted at the University Hospital Centre Zagreb and the University Hospital Merkur. Respondents and methods: the survey was conducted on 132 respondents, of whom 89 (67.4%) were employed at the University Hospital Centre Zagreb and 43 (32.6%) at the University Hospital Merkur. The respondents from both hospitals were employed at the Departments of Surgery. A questionnaire-scale was used as a research instrument to determine the general attitude and job satisfaction. Results: on the overall satisfaction scale, the respondents with the shortest work experience were significantly more satisfied, while those with longer work experience were significantly more dissatisfied. Overall satisfaction was significantly higher amongst the respondents from the University Hospital Centre Zagreb, the median stood at 117 (interquartile range from 107.5 to 125) (Mann Whitney U test, P = 0.007). The overall satisfaction score showed that 43 (33%) of the respondents were dissatisfied, 82 (62%) were either dissatisfied or satisfied, while only 7 (5%) respondents showed job satisfaction. Conclusion: the research study has shown that only 5% of nurses/medical technicians showed job satisfaction. Most respondents believed that they were not advancing as fast as in other professions and most of them were not satisfied with their career advancement opportunities

Pain assessment in patients with advanced dementia

Uvod: Starenje populacije donosi izazove u skrbi za starije osobe, posebno za one s Alzheimerovom demencijom. Ovaj tekst istražuje procjenu bola kod osoba s demencijom i koristi se različitim alatima za multidimenzionalnu procjenu bola. Cilj: Cilj je ovog rada istražiti i analizirati različite metode i alate za procjenu bola kod pacijenata oboljelih od demencije u uznapredovanoj fazi. Pregledom relevantne literature i analizom postojećih alata za procjenu bola kod neverbalnih i kognitivno oštećenih osoba, cilj je identificirati najefikasnije i najprimjenjivije alate za kliničku praksu. Metode: U istraživanju su korišteni pretraživači: Pub Med, CROSBI, Hrčak i Academia.edu. Pregledano je 70 izvora o procjeni bola uslijed demencije. Rezultati: Postoje alati za procjenu bola kod neverbalnih i kognitivno oštećenih osoba poput alata za procjenu neugodnosti u demenciji, popisa neverbalnih indikatora bola, instrumenti za procjenu bola nekomunikativnih pacijenata (NOPPAIN), kontrolnog popisa za procjenu bola starijih s otežanom komunikacijom (PACSLAC) i skale za procjenu bola kod uznapredovane demencije (PAINAD). Odabrano je sedam skala za procjenu bola koje se najčešće upotrebljavaju kod demencije, uključujući numeričku skalu, modificiranu neverbalnu skalu bola, PAINAD, Abbey skalu, Bolton alat za procjenu bola, McGillov upitnik za bol (MPQ) i kratki popis bola (BPI). Zaključak: Medicinske sestre primjenjuju holistički pristup pri procjeni bola kod demencije. Nedostatak standardizirane skale otežava preciznost mjerenja. Preporučuje se daljnje istraživanje i razvoj alata za bolju identifikaciju i upravljanje bolom. Edukacija osoblja važna je za poboljšanje kvalitete života osoba s demencijom. Kontinuirani napredak u razumijevanju bola ključan je za optimalnu skrb i dobrobit osoba s demencijom.Introduction: The aging population brings challenges in caring for elderly individuals, especially those with Alzheimer\u27s dementia. This text explores pain assessment in individuals with dementia, utilizing various tools for multidimensional pain evaluation. Aim: This research aims to explore and analyse different methods and tools for assessing pain in patients with advanced dementia. Through a review of relevant literature and analysis of existing tools for assessing pain in nonverbal and cognitively impaired individuals, the goal is to identify the most effective and applicable tools for clinical practice. Methods: In the research we used search engines: Pub Med, CROSBI, Hrčak, and Academia.edu. A total of 70 sources on pain assessment in dementia were reviewed. Results: Tools for pain assessment in non-verbal and cognitively impaired individuals include the Discomfort Scale in Dementia, Non-communicative Patient\u27s Pain Assessment Instrument (NOPPAIN), Pain Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC), and Pain Assessment in Advanced Dementia (PAINAD) scale. Seven commonly used pain assessment scales for dementia were selected, including the Numerical Rating Scale, Modified Non-Communicative Pain Scale, PAINAD, Abbey Pain Scale, Bolton Pain Assessment Tool, McGill Pain Questionnaire (MPQ), and Brief Pain Inventory (BPI). Conclusion: Nurses employ a holistic approach to pain assessment for individuals with dementia. The lack of a standardized pain assessment scale hinders measurement precision. Further research and development of tools for better pain identification and management are recommended. Staff education is crucial for improving the quality of life for individuals with dementia. Continuous progress in understanding pain is essential for optimal care and well-being of individuals with dementia

The mediating role of depressive, anxiety, and physical symptoms on work ability index in employed women with breast cancer: a prospective study from Croatia

Aim: To explore the relationship between the current work ability index (WAI) and depressive and anxiety symptoms in breast cancer (BC) patients and the role of depressive, anxiety, and physical symptoms in mediating this relationship. Methods: This prospective study enrolled 83 employed women with BC. At baseline assessment (in the first three months following BC diagnosis) and follow-up assessment (one year after baseline), participants completed the WAI, Beck Depression Inventory-II, State-Trait Anxiety Inventory, and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire with a breast cancer-specific module. Mediation analyses were conducted to explore the mechanism by which depressive, anxiety, and physical symptoms influenced the relationship between WAI and depressive and anxiety symptoms. Results: WAI was negatively associated with depressive and anxiety symptoms. The effect of baseline depressive and trait anxiety symptoms on WAI at follow-up was mediated by both depressive and trait anxiety symptoms, as well as by physical symptoms at follow-up. The effect of baseline state anxiety symptoms on WAI at follow-up was mediated only by state anxiety symptoms at follow-up. Conclusions: Baseline depressive and anxiety symptoms affect WAI at follow-up not only through persisting depressive and anxiety symptoms observed at follow-up but also through physical symptoms at follow-up. This indicates that efforts aimed at improving psychological health may result in simultaneous improvements in both psychological and physical health, as well as the resulting WAI