Impact of Intraoperative Factors on the Development of Postpartum Septic Complications

Publisher Copyright: © 2023 by the authors.Background and Objectives: Triclosan-coated sutures (antibacterial sutures) can reduce the risk of postoperative surgical site infection. This study aimed to investigate the effect of intraoperative factors, including antibacterial sutures, on the risk of postpartum septic complications. Materials and Methods: The prospective study included patients who underwent caesarean section. The exclusion criterion was chorioamnionitis. The investigation group patient’s (n = 67) uterus and fascial sheath of the abdominal wall were sutured with triclosan-coated polyglactin 910 sutures during surgery. The control group consisted of 98 patients using uncoated polyglactin 910 sutures only. The patients were contacted by phone after the 30th postoperative day. Results: No significant difference was found between the investigation group and the control group in the development of postpartum endometritis (11.7% in the investigation group vs. 8.4% in the control group, p = 0.401), wound infection (6.3% vs. 3.6%, p = 0.444) or patients experienced any septic complication (15.9% vs. 12%, p = 0.506). Postpartum endometritis was more common in patients who underwent instrumental uterine examination during the surgery (23.8% vs. 18%, p = 0.043). A moderately strong correlation was found for haemoglobin level on the third–fourth postoperative day with the development of postpartum septic complications, p < 0.001, Pearson coefficient −0.319. Post-caesarean delivery septic complications were not statistically more common in patients with blood loss greater than 1 L. The incidence of post-caesarean endometritis was 13.4%, and wound infection was 4.8% in this study’s hospital, having five to six thousand deliveries per year. Conclusions: Using antibacterial sutures during caesarean section does not affect the incidence of postpartum septic complications. Instrumental uterine examination during caesarean section increases the risk of post-caesarean endometritis and is, therefore, not recommended. Haemoglobin level on the 3rd–4th postoperative day, rather than the estimated blood loss during surgery, affects the development of postpartum septic complications.Peer reviewe

The influence of work in shifts on medical staff's psychoemotional health and patient safety

Maģistra darba tēma: Maiņu darba ietekme uz ārstniecības personu psihoemocionālo pašsajūtu un pacientu drošību. Darba mērķis ir izpētīt 24 stundu darba laika ietekmi uz ārstniecības personu psihoemocionālo pašsajūtu un ar to saistītos riskus attiecībā uz pacientu drošību. Darbā pētīti darba laika organizēšanas veidi un to ietekme uz Latvijas stacionāros strādājošām ārstniecības personām, kas sniedz valsts apmaksātus veselības aprūpes pakalpojumus diennakts stacionāros. Darba struktūra veidota četrās nodaļās, kurās apskatīts ārstniecības personas jēdziens, darba laika organizēšanas veidi, summētais darba laiks, maiņu darbs, nakts darbs, virsstundu darbs, psihoemocionālo pašsajūtu ietekmējošie faktori un to radītās sekas, veselības aprūpes kvalitātes riski un pacientu drošība. Darbā veikti secinājumi, ka liela daļa ārstniecības personu (aptuveni 50%) strādā 24 stundas vienā darba maiņā, kā arī vairāk nekā vienā darba vietā. Šāda situācija negatīvi ietekmē ārstniecības personu veselību un pašsajūtu, darba kvalitāti un tālākizglītības iespējas. Ārstniecības personu esošais nodrošinājums rada nopietnu apdraudējumu veselības aprūpes pakalpojumu nodrošināšanai nākotnē. Pētījumi par darba apstākļiem un riskiem Latvijā atspoguļo, ka psihoemocionālie riska faktori darba vidē ieņem būtisku vietu. Atslēgvārdi: diennakts maiņu darbs, ārstniecības persona, psihoemocionālā pašsajūta, veselības aprūpes kvalitātes riski.Master's thesis topic: the impact of shift work on psycho-emotional well-being and patient safety. Aim of the thesis: To investigate the impact of 24 h shifts on the psycho-emotional well-being of healthcare workers and the associated risks to patient safety. The paper investigates the types of working time organisation and their impact on healthcare workers in Latvian hospitals providing state-funded 24-hour healthcare services. The paper is structured in four chapters, which deal with the concept of a healthcare worker, types of working time arrangements, cumulative working time, shift work, night work, overtime, factors affecting psycho-emotional well-being and their consequences, risks to the quality of healthcare and patient safety. The paper concludes that a large proportion of healthcare workers (about 50%) work 24 hours per shift and at more than one workplace. This situation has a negative impact on the health and well-being of health care workers, on the quality of their work and on the opportunities for further training. The current supply of doctors poses a serious threat to the future provision of health services. Research on working conditions and risks in Latvia shows that psycho-emotional risk factors play an important role in the working environment. Keywords: 24h shift work, healthcare worker, psycho-emotional well-being, healthcare quality risks