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

MOTIVATION IN THE WORK OF NURSES-TECHNICIANS

Motivation in healthcare involves factors that encourage people to do their jobs in the best manner possible. Employee motivation is one of the key tasks and managerial functions. The basic is that motivation must be based on what we want to achieve, that is, reward things that we want more to be present, that is, encourage those behaviors that lead to the achievement of the organization\u27s goals. To nurses the key factors for work are motivation and satisfaction. Their satisfaction with work affects the quality of health care services provision, their availability and efficiency. The research are explorative and descriptive. The study used internal documents and regulations of the Human Resources Department of the University Clinical Center Sarajevo. The questionnaire survey was conducted among 301 nurses-technicians employed at the organizational units of the Clinical Center of the University of Sarajevo. The questionnaire survey was anonymous and the questionnaire was available in the electronic Google Forms platform. The survey was conducted in the period from July 01th 2019 to July 31st 2019. Non material compensation is a key motivator for nurses\u27 productivity. The research findings should serve to create nursing development strategies and strategies that promote quality of work at all levels of nursing practice

MANAGEMENT OF THE CLINICAL HEALTH CARE STANDARDIZATION PROCESS

An educated nurse has abilities to recognize and assess patients’ healthcare needs. Following the identified needs, the nurse organizes a healthcare process that meets the needs of patients. By standardizing education and professional practice, and recording the work of a nurse, the changes that are taking place in the nursing profession are recognizable. Certain activities related to the management and quality control of health services have set new requirements but also challenges for nurses and technicians. Traditional care, which until now was carried out exclusively on the doctor\u27s order, has now been replaced by modern health care. The purpose of modern health care is an individual approach for each patient, which is properly recorded in the health care documentation. The study is exploratory, descriptive, analytical, and comparative. The author\u27s original questionnaire was used as a study instrument, created based on a review of scientific and professional literature and experiences from clinical practice. The results of statistical data analysis are presented in tables and graphs by the absolute number of cases and percentages. Comparison and influence of individual factors were examined using the chi-square test, with test results considered significant at the 95% confidence level (p <0.05). The analysis was conducted using the IBM Statistics SPSS v 25.0 sociological study package (Chicago, Illinois, USA). Nurses believe that quality health care contributes to a faster process of treating patients in 91.6% of cases and that partial contributions are considered by 7.6% of them. Only one respondent believes that quality health care does not contribute to a faster healing process. Nurses believe that their colleagues provide the health care process in whole or in part in a quality, safe and equal way. This study confirmed that standardization has a positive impact on building the identity, integrity, and autonomy of the nursing profession, and it achieves the precondition for certification and accreditation of a health institution

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

MANAGEMENT OF THE CLINICAL HEALTH CARE STANDARDIZATION PROCESS

An educated nurse has abilities to recognize and assess patients’ health care needs. Following the identified needs, the nurse organizes a health care process that meets the needs of patients. By standardizing education and professional practice, and recording the work of a nurse, the changes that are taking place in the nursing profession are recognizable. Certain activities related to the management and quality control of health services have set new requirements but also challenges for nurses and technicians. Traditional care, which until now was carried out exclusively on the doctor\u27s order, has now been replaced by modern health care. The purpose of modern health care is an individual approach for each patient, which is properly recorded in the health care documentation. The study is exploratory, descriptive, analytical, and comparative. The author\u27s original questionnaire was used as a study instrument, created based on a review of scientific and professional literature and experiences from clinical practice. The results of statistical data analysis are presented in tables and graphs by the absolute number of cases and percentages. Comparison and influence of individual factors were examined using the chi-square test, with test results considered significant at the 95% confidence level (p <0.05). The analysis was conducted using the IBM Statistics SPSS v 25.0 sociological study package (Chicago, Illinois, USA). Nurses believe that quality health care contributes to a faster process of treating patients in 91.6% of cases and that partial contributions are considered by 7.6% of them. Only one respondent believes that quality health care does not contribute to a faster healing process. Nurses believe that their colleagues provide the health care process in whole or in part in a quality, safe and equal way. This study confirmed that standardization has a positive impact on building the identity, integrity, and autonomy of the nursing profession, and it achieves the precondition for certification and accreditation of a health institution

Upravljanje dokumentacijom zdravstvene njege u bolničkim uvjetima

Healthcare documentation or nursing documentation as often used in practice is the name of an indispensable part of a patient’s medical documentation, and documentation is an integral part of a nurse’s daily work. Documenting health care in the hospital means recording data on all procedures performed, during the entire health care process for the individual, all for the purpose of systematic monitoring, planning and evaluation of the quality of health care. Nursing documentation serves as a means of communication between the team and is of great importance for the quality and continuity of health care. AIMS: 1 - To determine the existence of health care documentation in hospital health care institutions; 2 - Examine the importance and purpose of documenting health care among nurses-medical technicians; 3 - Examine the practice of nurses-medical technicians in the process of administering health care; 4 - Present quality indicators that are monitored and analyzed through health care documentation; 5 - Compare the obtained results in two examined areas. METHODS: This research was conducted in two geographically separate areas of Sarajevo and Travnik. The study involved 210 respondents, 147 nurses-technicians employed at the Clinical Center of the University of Sarajevo and 63 nurses-technicians employed at the General Hospital in Travnik. Data collection for research was carried out by exploratory and descriptive method. An original authorized questionnaire was used for the descriptive research. The questionnaire was made available to respondents in the electronic form trough Google Forms. The anonymity of the respondents was fully guaranteed. The survey was conducted in the period from July 15- August 15, 2019. RESULTS: At the Clinical Center of the University of Sarajevo (CCU), 98% of respondents use health care documentation forms on a daily basis, and at the General Hospital Travnik 77.8% of respondents. In CCU Sarajevo, respondents use more standardized forms of health care documentation, 97.6%, compared to respondents in the General Hospital Travnik, where the documenting is carries out in nursing records, 74.6%. 68% of respondents at CCU Sarajevo believe that documentation contributes to the evaluation of nursing services, while only 19% of re-spondents at General Hospital Travnik believe the same. As the most common shortcomings, the respondents state the lack of computer technology in the department in 74.3%, then adequate premises for document administration in 37.6%, the lack of forms in printed form in 32.1% and 6 or 2.3% respondents did not answer this question. In both institutions, the biggest shortcoming is the problem of computer equipment in the department, in 70.7% in CCU Sarajevo and 82.5% in General Hospital Travnik. CONCLUSIONS: The research found that over 95% of respondents use standardized health care processes in their daily practice, document health care, know the basic purpose and monitor health care indicators. More than 90% of respondents in both study groups use health care documentation to plan health care and monitor its outcomes. More than half of respondents in both study groups stated that documenting health care is a problem because it consumes a lot of time. A larger number of respondents from both groups, as many as 30%, state that they do not use the data from the health care documentation for any purpose. The lack of workers in the health care process, insufficient knowledge of information technologies, and the lack of an information system represent an aggravating circumstance in documenting the health care process.Dokumentacija zdravstvene njege ili sestrinska dokumentacija, kako se često naziva u praksi, neizostavan je dio medicinske dokumentacije pacijenta, a dokumentiranje je sastavni dio svakodnevnoga sestrinskog posla. Dokumentiranje zdravstvene njege u bolnici podrazumijeva zapisivanje podataka o svim provedenim postupcima tijekom cjelokupnog procesa zdravstvene njege za pojedinca, a sve u svrhu sustavnog praćenja stanja te planiranja i vrednovanja kvaliteta zdravstvene njege. Sestrinska dokumentacija služi kao sredstvo komunikacije između tima i od velike je važnosti za kvalitetu i kontinuitet zdravstvene njege. CILJEVI RADA: 1. Utvrditi postojanje dokumentacije zdravstvene njege u bolničkim zdravstvenim ustanovama. 2. Ispitati praksu medicinskih sestara/tehničara u procesu administriranja zdravstvene njege. 3. Prikazati indikatore kvalitete koji se prate i analiziraju putem dokumentacije zdravstvene njege. 4. Komparirati dobivene rezultate u dva ispitivana područja. METODE RADA: Ovo istraživanje provedeno je na dva geografski odvojena područja, u Sarajevu i Travniku. U istraživanju je sudjelovalo 210 ispitanika, i to 147 medicinskih sestara/tehničara zaposlenih u Kliničkom centru Univerziteta u Sarajevu i 63 medicinske sestre / medicinska tehničara zaposlena u Općoj bolnici u Travniku. Prikupljanje podataka za istraživanje provedeno je deskriptivnom metodom. Za deskriptivno istraživanje primijenjen je originalni autorski upitnik. Upitnik je ispitanicima bio dostupan u elektroničkom obliku u internetskoj aplikaciji Google Forms. Anonimnost ispitanika bila je u potpunosti zajamčena. Istraživanje je provedeno u periodu od 15. srpnja do 15. kolovoza 2019. REZULTATI ISTRAŽIVANJA:U Kliničkom centru Univerziteta u Sarajevu 98 % ispitanika svakodnevno upotrebljava obrasce dokumentacije zdravstvene njege, a u Općoj bolnici Travnik 77,8 % ispitanika. U KCU-u Sarajevo ispitanici više upotrebljavaju standardizirane obrasce dokumentacije zdravstvene njege, i to 97,6 %, u odnosu na ispitanike u Općoj bolnici u Travniku, gdje se dokumentiranje vrši u sestrinske evidencijske bilježnice, i to 74,6 %. 68 % ispitanika u KCU-u Sarajevo smatra da dokumentiranje pridonosi vrednovanju sestrinskih usluga, dok to smatra samo 19 % ispitanika iz Opće bolnice Travnik. Kao najčešće nedostatke ispitanici navode nedostatak računalne tehnike na odjelu (74,3 %), zatim neadekvatne prostorije za administriranje dokumentacije (37,6 %) te nedostatak obrazaca u tiskanom obliku (32,1 %), a na ovo pitanje nije odgovorilo šest ili 2,3 % ispitanika.U obje ustanove kao najveći nedostatak navode problem računalne opreme na odjelu, i to 70,7 % u KCU-u Sarajevo i 82,5 % u OB-u Travnik. ZAKLJUČCI: Istraživanjem je utvrđeno da više od 95 % ispitanika u svakodnevnoj praksi primjenjuje standardizirane procese zdravstvene njege, dokumentira zdravstvenu njegu, poznaje osnovnu svrhu i prati indikatore zdravstvene njege. Više od 90 % ispitanika u obje ispitivane skupine dokumentacijom zdravstvene njege kori-sti se za planiranje zdravstvene njege i praćenje njezinih ishoda.Više od polovine ispitanika u obje ispitivane skupine navelo je da im dokumentiranje zdravstvene njege predstavlja problem jer im oduzima mnogo vremena u radu. Veći broj ispitanika obje ispitivane skupine, čak 30 %, navodi da se podacima iz dokumentacije zdravstvene njege ne koriste ni u kakve svrhe. Nedostatak izvršitelja procesa zdravstvene njege, nedovoljno znanje o informacijskim tehnologijama te nepostojanje informacijskog sustava predstavlja otežavajuću okolnost u dokumentiranju procesa zdravstvene njege

BIOETIČKO ODLUČIVANJE U KLINIČKOJ SESTRINSKOJ PRAKSI

Introduction: Nursing as a profession and vocation is understood as humanity, altruism and dedication. Nurses possess 4 types of responsibilities: human, legal, ethical and professional, within which protective models are oriented to the well-being of the patient. The values, rules and principles within nursing practice are regulated by codes of ethics. Aim: To determine the infl uence of knowledge, positive attitude and love for the profession, as well as practices based on high moral and ethical principles in graduate nurses on making ethical decisions in work with patients. Material and methods: The study was conducted among 106 graduate nurses of the Clinical Center of the University of Sarajevo. The study was descriptive, transverse according to the cross-sectional type. The study was conducted in the period from June 1, 2019 to September 30, 2019. Statistical data processing was performed using the χ2-test, Fisher test, Mann-Whitney U test, and other tests. Results: The majority of respondents (89.4%) stated that they chose nursing profession out of love and desire to help sick people. The largest number of respondents make ethical decisions independently in the implementation of appropriate health care (84%), 62.3% are considered religious, but 77.7% of them believe that religiosity does not affect ethical decision making. Half of the respondents stated that they were in a situation to act as a legal protector for patients in case they noticed that they could be harmed. The majority of respondents (84%) did not have a situation to make wrong ethical decision in their practice. Conclusion: Our study confi rms that in order to make ethical decisions in working with patients, graduate nurses must have quality knowledge, a positive attitude and love for the profession, and a practice based on high moral and ethical principles.Uvod: Sestrinstvo kao profesija i poziv shvaćeno je kao humanost, altruizam i predanost. Medicinske sestre imaju 4 vrste odgovornosti i to: ljudska, pravna, etička i profesionalna, a unutar kojih se prožimaju zaštitnički modeli usmjereni na dobro bolesnika. Vrijednosti, pravila i načela unutar sestrinske prakse regulirani su etičkim kodeksima. Cilj: Utvrditi utjecaj znanja, pozitivno izgrađenog stava i ljubavi prema struci, kao i prakse zasnovane na visokim moralnim i etičkim načelima kod diplomiranih medicinskih sestara na donošenje etičkih odluka u radu s bolesnicima. Materijal i metode: Istraživanje je provedeno među 106 diplomiranih medicinskih sestara Kliničkog centra Univerziteta u Sarajevu. Istraživanje je deskriptivno, transverzalno prema tipu poprečne (cross-sectional) studije. Istraživanje je provedeno u razdoblju od 1. lipnja 2019. do 30. rujna 2019. godine. Statistička obrada podataka učinjena je uz primjenu χ²-testa, Fisherova testa, Mann-Whitneyeva U testa i drugih testova. Rezultati: Većina ispitanika (89,4 %) izjavila je da su sestrinsku struku odabrali iz ljubavi i želje da pomažu bolesnim osobama. Najveći broj ispitanika samostalno donosi etičke odluke kod provođenja odgovarajuće zdravstvene njege (84 %), 62,3 % se smatra religioznim, međutim 77,7 % ih smatra da religioznost ne utječe na donošenje etičkih odluka. Polovina ispitanih navodi kako su bili u situaciji da se ponašaju kao pravni zaštitnik bolesnika kada primijete da bi im se mogla nanijeti šteta. Većina ispitanika (84 %) nije bila u situaciji da u svojoj praksi donesu pogrešnu etičku odluku. Zaključak: Rad potvrđuje da za donošenje etičkih odluka u radu s bolesnicima diplomirane medicinske sestre moraju imati kvalitetno znanje, izgrađen pozitivan stav i ljubav prema struci te praksu zasnovanu na visokim moralnim i etičkim načelima

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