Smjernice u radu operacijskih sestara instrumentarki

Introduction. The use of guidelines in the work of operating room nurses makes daily tasks easier and enables treatment in accordance with set procedures based on scientific evidence. Additionally, the use of set guidelines in the work of operating room nurses enables traceability of healthcare and the best care for the patient, which also increases the safety of the patient in the operating room during the perioperative period. Aim. The goal of this article is to investigate and determine if operating room nurses are aware of the guidelines, if they use them in their daily work, and if the guidelines are available at their workplace. The goal is also to determine the opinion of operating room nurses about legal protection that the guidelines provide in case of unforeseen events, as well as the necessary level of education of the personnel setting the guidelines, and the effect of the guidelines on the patient\u27s safety in the operating room. Additionally, it is to determine if the use of the guidelines reduces inconsistencies in the work of operating room nurses in different hospitals, and which institutions are in charge of setting them. Methods. The survey for this research was conducted by the author of this paper and was distributed at the Congress of Operating Room Nurses in October of 2019. 210 operating room nurses completed the survey, being of different levels of formal education, and are employees of various Clinical Hospital Centres, Clinical Hospitals and General Hospitals in the Republic of Croatia. Results. According to the results of the survey, 90 respondents were Bachelors of Nursing, 60 respondents had a university degree, and 60 respondents had a high school diploma. The length of work experience of the operating room nurses who participated in the survey was between 1 and 30 years. The results of the research showed that the majority of operating room nurses were familiar with the existence of the guidelines and recommendations, and they used them in their work. Results show that most respondents are aware of the need to use the guidelines, and that they are available at their work place. Results also show that operating room nurses feel that the use of the guidelines has a very strong influence on the level of patient safety. Operating room nurses know that the guidelines provide legal protection and that the level of the nurses\u27 education is important for setting the guidelines. Conclusion. Operating room nurses use the guidelines in daily work whenever they are applicable. Respondents have also developed an awareness of the obligation to use the guidelines, as well as their benefits in improving patient safety. They also provide legal protection in the event of unforeseen circumstances.Uvod. Primjena smjernica u radu operacijskih sestara instrumentarki uvelike olakšava njihov svakodnevni rad i omogućuje postupanje u skladu s propisanim procedurama koje su zasnovane na znanstvenim dokazima. Također, primjena smjernica u svakodnevnom radu operacijskih sestara instrumentarki omogućuje je sljedivost zdravstvenog postupka i najbolju moguću skrb za bolesnika, što ujedno povisuje razinu sigurnosti bolesnika u operacijskoj sali tijekom perioperacijskog perioda. Cilj. Cilj je ovog rada istražiti i utvrditi imaju li operacijske sestre informacije o postojanju smjernica, primjenjuju li operacijske sestre instrumentarke smjernice u svojem svakodnevnom radu i jesu li im smjernice dostupne na radnim mjestima. Također, cilj je rada utvrditi stav operacijskih sestara instrumentarki o pravnoj zaštiti koju omogućuje primjena smjernica u slučaju nastanka neželjenog događaja, potrebnoj razni edukacije osoba koje sudjeluju u izradi smjernica, utjecaju primjene smjernica na razinu sigurnosti bolesnika u operacijskoj sali, utvrditi smanjuje li primjena smjernica varijabilnosti u radu operacijskih sestara instrumentarki između pojedinih zdravstvenih ustanova te koje su institucije nadležne za izradu smjernica. Metode. Upitnik za potrebe ovog istraživanja izradio je autor rada i distribuiran je na Stručnom skupu operacijskih sestara koji je održan u listopadu 2019. U ispunjavanju anketnog upitnika sudjelovalo je 210 operacijskih sestara i tehničara instrumentara, koji su različitih razina formalne edukacije i zaposlenici su kliničkih bolničkih centara te kliničkih i općih bolnica u Republici Hrvatskoj. Rezultati. Prema rezultatima anketnog upitnika, ispitanici su najvećim dijelom prvostupnici sestrinstva, ukupno 90 ispitanika, 60 ispitanika medicinske su sestre i tehničari visoke stručne spreme, 60 ispitanika medicinske su sestre i tehničari srednje stručne spreme. Broj godina rada ispitanika u operacijskim salama kreće se od jedne do 30 i više godina. Rezultati istraživanja pokazali su da je najveći dio operacijskih sestara instrumentarki upoznat s postojanjem smjernica i preporuka za rad te ih primjenjuju u svojem svakodnevnom radu. Također, rezultati pokazuju da je kod najvećeg dijela ispitanika razvijena spoznaja o obvezi primjene smjernica za rad i da su smjernice za rad dostupne na radnim mjestima. Rezultati pokazuju kako operacijske sestre i tehničari smatraju da upotreba smjernica ima snažan utjecaj na razinu sigurnosti bolesnika, kao i da smjernice omogućuju pravnu zaštitu i da je za izradu smjernica važna razina edukacije medicinskih sestara. Zaključak. Zaključak je da operacijske sestre instrumentarke redovno primjenjuju smjernice kad su im god dostupne. Također kod ispitanika je razvijena svijest o obvezi primjene smjernica i njihovim koristima u unaprjeđenju sigurnosti bolesnika, kao i o tome da smjernice omogućuju pravnu zaštitu u slučaju neželjenog događaja

Coping with Stress of Nurses Employed in the Internal Medicine and Surgical Departments

Introduction. Stress is a state of tension that arises when events or requests from the environment are assessed as threatening or too demanding. in the process of coping, we use different cognitive and behavioral strategies. problem-oriented coping involves strategies aimed at changing or removing stressors. emotion-focused coping encompasses stress-induced arousal management strategies. no coping strategy is universally effective, but the success of coping is assessed in the interaction of an individual’s characteristics and a stressful situation. The prevalence of individual coping patterns among nurses may depend on their workplace. Aim. To determine nurses in the internal medicine and surgical departments of two croatian hospitals cope with stress. Methods. The participants were 163 nurses from the internal medicine and surgical departments of the Sisak general Hospital “dr. Ivo Pedišić” and the general Hospital Karlovac. The measuring instruments used are the Questionnaire on how to deal with stress and the Scale for assessing the importance of events and the possibility of control. Results. The most common ways of coping with stress are planned problem solving, seeking social support, and self-control, while the rarest way of coping is avoidance. nurses perceive the success of coping with stress as moderate, and the degree of control over stressful situations as rather low. Stressful situations are most often perceived as a threat, and least often as a challenge.With the perception of a greater degree of control over the situation, they more often choose to accept responsibility as a way of coping. In internal medicine departments, stressful events are assessed as significantly more disturbing than in surgical departments. Conclusion. The results confirm that for further education of nurses on successful coping with stress, it is important to examine and further explore cognitive processes in selecting ways of coping: the meaning they attach to the situation, assessing control over the situation, and self-assessing coping success

Utjecaj plinovitog ozona na kakvoću zraka u bolničkom okružju

Even though ozone has shown its potential for air disinfection in hospital environment, its more frequent use has earned attention only with the COVID-19 pandemic due to its proven antimicrobial effect and low cost of production. The aim of this study was to determine its antimicrobial efficiency against the most common bacterial species in a real-life setting, that is, in the air of one postoperative room of the General Hospital Dr Ivo Pedišić (Sisak, Croatia). Air was sampled for aiborne bacteria before and after treatment with the ozone concentration of 15.71 mg/m3 for one hour. The most dominant Gram-positive bacteria of the genera Micrococcus, Staphylococcus, and Bacillus were reduced by 33 %, 58 %, and 61 %, respectively. The genus Micrococcus proved to be the most resistant. Considering our findings, we recommend longer air treatment with higher ozone concentrations in combination with mechanical cleaning and frequent ventilation.Bolničke infekcije mogu se prenijeti zrakom pa je higijena zraka u bolničkim sobama važan preventivni čimbenik. Standardne metode dezinfekcije nisu dovoljne za potpuno uništavanje bakterija u zraku te je potrebno pronaći odgovarajuću metodu dezinfekcije zraka. Primjena plinovitih dezinficijensa pokazala se učinkovitom, a ozon je potencijalni kandidat za dezinfekciju zraka u bolničkom okružju zbog dokazanog antimikrobnog učinka i niske cijene proizvodnje. Svrha ovog istraživanja bila je utvrditi antimikrobni učinak plinovitog ozona na kakvoću zraka bolničke sobe i identificirati standardne bakterije, raspršene u zraku. Istraživanje je provedeno u bolničkoj sobi Opće bolnice “Dr. Ivo Pedišić” u Sisku. Zrak je bio uzorkovan na različitim mjestima u prostoriji prije i nakon tretmana ozonom u trajanju od 1 sata / 15, 71 mg/m3. Nadalje, identifikacija i kvantifikacija vrsta bakterija provedena je u uzorkovanom zraku na različitim lokacijama. Dominirale su gram-pozitivne bakterije iz rodova Micrococcus, Staphylococcus i Bacillus. Nakon tretmana, broj bakterija u zraku smanjen je 33 %, 58 % i 61 %, ovisno o lokaciji uzorkovanja, a najotpornijima su se pokazale bakterije iz roda Micrococcus. Plinoviti ozon prouzročuje značajno smanjenje mikroorganizama koji su raspršeni u zraku u česticama prašine i kapljicama u bolničkoj sobi. Preporučuje se produljeno djelovanje s većim koncentracijama ozona u kombinaciji s mehaničkim čišćenjem i čestim prozračivanjem