Zapewnienie bezpieczeństwa choremu w trakcie hospitalizacji jako wymiar jakości opieki

Introduction: The maintenance and development of        hospitals in a market-based health care system is associated        with an improvement in the quality of medical services. At        the same time, there is a need for an objective evaluation        of the level of nursing using various research methods and        instruments. Among these instruments is a questionnaire for        the assessment of the level of nursing care -BOHIPSZO.        Material and methods: The evaluation covered        640 patients, who constituted 19.2% of those who received        treatment in 143 wards in 45 hospitals in Poland, where        the studies were conducted during the period 2009 – 2012.        The research instrument was a questionnaire form for the        assessment of the level of nursing care BOHIPSZO according        to H. Lenartowicz.        Results: Based on the analysis of the study material        it was found that the quality of nursing care from the aspect of        provision of patient safety during hospitalization is on a higher        level in hospitals with accreditation or the ISO certificate,        compared to those which do not possess quality certificates  (p<0.001). Conclusions: The preparation of a hospital for accreditation in accordance with the accreditation criteria, and for the certification audit according to the requirements of the standard PN EN ISO 9001:2009 has a motivating effect on the employees with respect to the provision of adequate conditions of the environment of patient care during hospitalization, which is a precondition for a higher level of patient care in hospitals with the quality certificate.         Utrzymanie i rozwój szpitali w rynkowym systemie ochrony zdrowia wiąże się z doskonaleniem jakości świadczeń medycznych. Jednocześnie istnieje potrzeba obiektywnej oceny poziomu pielęgnowania przy pomocy różnych metod i narzędzi badawczych. Jednym z narzędzi jest arkusz oceny poziomu pielęgnowania – BOHIPSZO. Materiał i metody: Ocenie poddano 640 pacjentów, co stanowiło 19,2% z tych, którzy byli leczeni w 143 oddziałach, w 45 szpitalach w Polsce, gdzie były prowadzone badania w latach 2009 - 2012. Narzędziem badawczym był kwestionariusz oceny poziomu pielęgnowania BOHIPSZO według H. Lenartowicz. Wyniki: Na podstawie analizy materiału badawczego stwierdzono, że jakość opieki pielęgniarskiej w aspekcie zapewnienia bezpieczeństwa pacjenta podczas hospitalizacji jest na wyższym poziomie w szpitalach z akredytacją lub certyfikatem ISO, w porównaniu do tych, które nie posiadają certyfikatów jakości (p <0,001). Wnioski: Przygotowanie szpitala do akredytacji zgodnie z kryteriami akredytacyjnymi oraz do audytu certyfikującego zgodnie z wymaganiami normy PN-EN ISO 9001:2009 ma wpływ na motywację pracowników w zakresie zapewnienia prawidłowych warunków środowiska opieki nad pacjentem podczas hospitalizacji, co determinuje wyższy poziomu opieki nad chorym w szpitalach z certyfikatem jakości

An evaluation of the impact of rehabilitation on the quality of life in patients after cerebral stroke

Cerebral stroke is the third most frequent cause of death in the human population, and one of leading causes of long-lasting disability. Medical rehabilitation has proven to be an indispensable element in stroke management. The aim of this study is to evaluate the quality of life in patients after a cerebral stroke, before and after rehabilitation. This analysis was based on data obtained from an empirical study conducted on 70 people after a stroke. The research was performed with the use of an original survey questionnaire. Due to their conditions, respondents perceived varying degrees and extents of changes in their organisms and environments pertaining to their physical, psychological, social, and professional spheres of life. In the vast majority of the patients, applied rehabilitation had a positive influence on their quality of life. There was an improvement in their physical and psychological conditions, as well as in various other aspects of life, while the intensity of emerging disorders decreased

Injuries treated in hospital among urban and rural inhabitants of eastern Poland

Introduction and objective Injuries are a serious medical and social problem, especially when accompanied by distant or deferred effects, often causing serious dysfunctions and permanent disability for life. The study aimed at presenting the incidence of injuries of urban and rural population treated in a district hospital in eastern Poland. Material and Methods The study was carried out in the Independent Public Health Care Institution in Kraśnik in 2011 among patients hospitalized in the Department of Trauma Surgery and Orthopedic Unit who sustained injuries. Medical records of 795 patients – 326 women and 469 men, aged 10–99 years, were analyzed. Results During the period considered among those hospitalized due to injuries, men (59%), those aged 50–59 years (19.0%), and living in rural areas (72.7%) predominated. Injuries most commonly affected the head (18.87%), elbow and forearm (16.86%), knee and lower leg (16.60%), and the hip and thigh (13.96%). Average hospital stay was 5.65 days and was the longest for hip and thigh injuries (11.86 days). Conclusions Injuries occurred most frequently in the population of patients living in rural areas, often among men, usually on weekdays and in the mornin

Maternal pre-pregnancy obesity and the risk of preterm birth: a systematic overview of cohort studies with meta-analysis

Objective: Despite numerous studies assessing the risk of preterm birth in obese women compared with normal weight patients, the scope of the association remains unclear. Therefore, we conducted a systematic overview and meta-analysis to summarize the available evidence from cohort studies on the relationship between maternal obesity and the risk of preterm birth. Methods: We searched bibliographic database: MEDLINE (PubMed) and EMBASE for all relevant articles, with no language restrictions, which were published from January 1990 to September 2010, using a combination of the following search terms: maternal obesity or high body mass index (BMI) and preterm birth or pregnancy outcome. Crude odds ratios (OR) for individual outcomes were calculated for each study and were pooled by using the random-effects model. Results: Twenty seven studies proved eligible under the selection criteria. The crude OR of preterm birth were 1.18 [95% confidence interval (CI) 1.07 to 1.30], 1.28 (95% CI 0.93 to 1.75) and 1.11 (95% CI 0.98 to 1.25) among obese, severely obese and morbidly obese women, respectively, compared with normal weight women. We found an elevated risk of induced preterm birth among obese (OR 1.72, 95% CI 1.45 to 2.04), severely obese (OR 1.70, 95% CI 1.32 to 2.18) and morbidly obese pregnants (OR 1.66, 95% CI 1.33 to 2.07) but a reduction in the risk of spontaneous preterm birth: OR = 0.98 (95% CI 0.80 to 1.20), OR=0.85 (95% CI 0.55 to 1.31) and OR=0.77 (95% CI 0.60 to 0.99), respectively. Obese women, independently of category the of obesity, also are at a higher risk of very preterm delivery (

Meeting needs for rehabilitation equipment and home adjustments among the disabled in their life environment

Introduction The elimination of functional barriers resulting from disability through the provision of adequate orthopaedic and rehabilitation equipment, and homes adjusted for disability is the precondition for an efficient and independent functioning, and high quality of life of the disabled. The objective of the study was recognition of the needs of the disabled declared by them, and the degree of satisfaction with these needs. Material and Methods The study covered 478 disabled from the Lublin Region. The research instrument was the ‘Questionnaire for the Disabled’ designed by the authors. Results Considering the needs expressed by the respondents concerning the provision of orthopaedic and rehabilitation equipment and meeting these needs, four groups were distinguished: No Needs – 30.1%, Needs Partially Met – 22.4%, Needs Fully Met – 37.7%, Needs Not Met – 9.8%. The group Needs Not Met was characterized by younger age, in the group Needs Partially Met worse indicators of the state of health were noted, more frequent independent living, loneliness and low material standard. Considering the expressed needs for home adjustments adequate to disability and meeting these needs, three groups were distinguished: No Needs – 59.6%, Needs Not Met – 15.9%, and Needs Met – 24.7%. The group Needs Not Met more rarely covered respondents living in residential homes, compared to those living independently in rural or urban areas. The group Needs Met more rarely included rural inhabitants, while more frequently including the disabled who had a high material standard. Conclusions Both the provision of orthopaedic equipment and adjustment of the home to disability are insufficient with respect to the needs. The meeting of these needs is significantly conditioned by high or very high material standard. The lack or incomplete satisfaction with the needs for rehabilitation equipment is associated with a relatively younger age, independent, single residence and low material standard. Living in an residential home means better adjustment of the living environment, and better provision with orthopaedic and rehabilitation equipment

Vaccination against influenza among medical students of selected Medical Universities in Poland in the 2014/2015 influenza season

Vaccinations against influenza are one of the most beneficial elements of prevention. Adoption of measures to popularize vaccination among reluctant to be vaccinated against influenza Polish population, especially in the environment of future doctors should be one of the priorities in the universities. The article analyzes the level of basic knowledge, opinions and declared behaviors related to influenza and its prevention among medical students of selected Medical University in Poland. The study included 1,031 individuals during the 2014/2015 epidemic. It represented a diverse population of sex, age, place of residence. For the purpose of the research an original questionnaire was used. The results were subjected to statistical analysis, which reveals that only 76 individuals got inoculated against influenza, which accounted for only 7.37% of the study population of students studying in various academic centers in Poland. Analysis of own research shows that regularly over the last five influenza seasons only 70 individuals (6.79%) have got inoculated, while the vast majority – 72.45% of the population did not get inoculated at all, and 20.75% occasionally declared inoculation against the influenza. Despite seasonal influenza epidemics, undertaken educational and preventive tests among vulnerable group rather a pessimistic picture emerges of the Polish population

High doses of medroxyprogesterone as the cause of disappearance of adherence of the zona pellucida to an oocyte

The zona pellucida (ZP) is an external glycoprotein membrane of oocytes of mammals and embryos in the early stage of their development. ZP first appears in growing ovarian follicles as an extracellular substance between the oocyte and granular cells. The zona pellucid markedly affects the development and maturation of the oocyte. The morphology of the ZP-oocyte complex allows a more precise determination of the oocyte maturity. According to numerous experimental studies, ZP is essential for preimplantation embryonic development of humans and other mammals. It prevents dispersion of blastomeres and enhances their mutual interactions. ZP is a dynamic structure responsible for the provision of nutrients to early forms of oocytes in mammals. The aim of the present study was untrastructural evaluation of the ZP-oocyte contact during inhibited ovulation. Female white rats (Wistar strain) received a suspension of medroxyprogesterone acetate (MPA) in incremental intramuscular bolus doses of 3.7 mg (therapeutic dose), 7.4 mg and 11.1 mg. The animals were decapitated 5 days after the administration of MPA. Ovarian sections were evaluated under a transmission electron microscope (TEM) Zeiss EM 900. Morphometric analysis of ZP was conducted using the cell imaging system by Olympus. In females exposed to therapeutic doses of MPA, ZP showed the structure of granular-fibrous reticulum of a medium electron density with single cytoplasmic processes originating from the surrounding structures. The oocyte cell membrane generated single, delicate processes directed toward ZP. Microvilli of the oocyte were short and thin. In the group receiving 7.4 mg of MPA, ZP had the structure of a delicate, loose granular-fibrous reticulum, and the oocyte cell membrane generated single microvilli directed toward ZP. In both those groups, the close ZP-oocyte contact was observed. Otherwise, in the group exposed to the highest MPA doses (11.1 mg), thicker and more numerous oocyte microvilli were found, which did not penetrate ZP matrix. They were dense, irregularly separated contour, forming a barrier between ZP and oocyte. The present findings are likely to suggest that MPA has inhibiting effects on the synthesis of binding proteins and causes the loss of the oocyte contact with ZP

Injuries treated in hospital among urban and rural inhabitants of eastern Poland

Introduction and objective Injuries are a serious medical and social problem, especially when accompanied by distant or deferred effects, often causing serious dysfunctions and permanent disability for life. The study aimed at presenting the incidence of injuries of urban and rural population treated in a district hospital in eastern Poland. Material and Methods The study was carried out in the Independent Public Health Care Institution in Kraśnik in 2011 among patients hospitalized in the Department of Trauma Surgery and Orthopedic Unit who sustained injuries. Medical records of 795 patients – 326 women and 469 men, aged 10–99 years, were analyzed. Results During the period considered among those hospitalized due to injuries, men (59%), those aged 50–59 years (19.0%), and living in rural areas (72.7%) predominated. Injuries most commonly affected the head (18.87%), elbow and forearm (16.86%), knee and lower leg (16.60%), and the hip and thigh (13.96%). Average hospital stay was 5.65 days and was the longest for hip and thigh injuries (11.86 days). Conclusions Injuries occurred most frequently in the population of patients living in rural areas, often among men, usually on weekdays and in the mornin