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ABSTRACT Background. The health system responsiveness, defined as non-medical aspect of treatment relating to the protection of the patients’ legitimate rights, is the intrinsic goal of the WHO strategy for 21st century. Objective. To describe the patients’ opinions on treatment they received in hospital, namely: admission to hospital, the role of patient in hospital treatment, course of treatment, medical workforce attitude, hospital environment, contact with family and friends, and the efficacy of hospital treatment in respect to responsiveness to patient’s needs and expectations (dignity, autonomy, confidentiality, communication, prompt attention, social support, basic amenities and choice of provider). Material and methods. The data were collected in 2012 from 998 former patients of the randomly selected 73 hospital in Poland. Results. Dignity: Over 80% of patients experienced kindness, empathy, care and gentleness, and over 90% of them had the sense of security in hospital, met with friendliness during the admission to hospital and never encountered inappropriate comments from medical staff. Autonomy: About 80% of patients accepted the active role of patients in hospital, they perceived they had influence on procedures related to hospitalization and course of treatment, and they felt medical staff responded to their requests and concerns. Over 90 % of them had opportunity to communicate their concerns to medical staff and to discuss the course of treatment. On the other hand, the explanation of the reason for the refusal to meet their requests was given to only 23 % of the patients interested. Confidentiality: 70-80 % of patients declared the respect for privacy and confidentiality during collecting the health information and during medical examinations, and were not examined in presence of other people. Nevertheless, only 23% of patients examined so were asked of their consent. Communication: About 90% of patients declared they trusted their physician, received from him explanation regarding the course of treatment and information about further treatment after discharge from hospital, but physicians devoted the time and attention to only 70% of them. Prompt attention: Over 90% of patients perceived simplicity of the formalities of admission to hospital, and short waiting for treatment and additional tests in hospital (but only 50% received explanation of reason if they waited long). Nevertheless, 10% of them % of them perceived they waited for admission to hospital too long, and over 20% for admission to a ward as long. Social support: The unlimited direct and phone contact with family and friends was declared by 96% of patients. Basic amenities: The high percentage of patients assessed positively the marking in hospital (97%) and cleanliness of linen (89%), followed by the general indoor appearance room in which patient stayed, lack of noise (70-80%), hospital meals, furniture (60-70%), availability of personal hygienic articles (50-60%), cleanliness of hospital room, toilet, showers and bathtubs, and availability of soap (40-50%). Choice of provider: Only 41% of patients declared that they had influence on choice of the hospital. Conclusion. Responsiveness of Polish hospital patient needs is similar to that of the OECD countries of the lowest health system responsiveness. Compared to the Central European countries, the responsiveness in Polish hospitals is lower than that of Czech Republic and only slightly higher of those of Slovenia, Slovakia and Hungary.
The goal of this paper is to assess any possible relationships between the types of behaviors and coping strategies with occupational stress among nurses. Workplace has an important position in the life of a contemporary person. It can be a source of great satisfaction and positive experiences or it can be a source of frustration and negative influence on ones health. Sample: The sample consisted of 242 nurses from various hospitals in Bydgoszcz. Method: The research was conducted by the means of two questionnaires: first, AVEM - Questionnaire, which describes four types of behaviors and second, Latack's Coping Scale - which describes five coping factors with occupational stress. The analysis of the results indicates that the types of behavior in the workplace influence the strategies of coping with occupational stress.
Infections related to modern surgical procedures present a difficult problem for contemporary medicine. Infections acquired during surgery represent a risk factor related to therapeutical interventions. Eradication of microorganisms from hospital operating theatre environment may contribute to reduction of infections as the laminar flow air-conditioning considerably reduces the number of microorganisms in the hospital environment. The objective of the study was to evaluate the occurrence of fungi in air-conditioned operating theatre rooms. The study was carried out in one of the hospitals in Kraków during December 2009. Indoor air samples and imprints from the walls were collected from five operating theatre rooms. A total of fifty indoor air samples were collected with a MAS-100 device, and twenty five imprints from the walls were collected using a Count Tact method. Fungal growth was observed in 48 air samples; the average numbers of fungi were within the range of 5–100 c.f.u. in one cubic metre of the air. Fungi were detected only in four samples of the wall imprints; the number of fungi was 0.01 c.f.u. per one square centimetre of the surface. The mould genus Aspergillus was most frequently isolated, and the species A. fumigatus and A. versicolor were the dominating ones. To ensure microbiological cleanness of hospital operating theatre, the air-conditioning system should be properly maintained. Domination of the Aspergillus fungi in indoor air as well as increase in the number of moulds in the samples taken in evenings (p<0.05) may suggest that the room decontamination procedures were neglected.
U ogromnej większości ludzi starszych, a mianowicie u tych, którzy mieszkają w domu problemy żywieniowe są raczej natury jakościowej niż ilościowej, przynajmniej w krajach uprzemysłowionych. Inna grupa ryzyka odznacza się niemalże przeciwnym problemem, na przykład większym zapotrzebowaniem na energię, a także na niezbędne składniki odżywcze. Niemożność zaspokojenia tego zapotrzebowania przyczyniła się do powstania koncepcji niedożywienia szpitalnego, która została zastosowana i opisana w kilku krajach. Wielu pacjentów, o których się mówi, że cierpią z powodu niedożywienia szpitalnego, faktycznie choruje z powodu niedożywienia spowodowanego chorobą podstawową. Jednak u wielu pacjentów szpitalnych etiologia niedożywienia jest wieloczynnikowa, z elementami zarówno szpitalnymi jak i chorobowymi. Ciężkie stany niedożywienia można łatwo zdiagnozować zestawem metod klinicznych i laboratoryjnych. Jednak przypadki z pogranicza wykryć jest trudno. Sama choroba może spowodować pogorszenie apetytu, zaburzenia żołądkowo-jelitowe, a nawet wymioty. Ponadto schorzeniom nowotworowym, a także innym stanom, towarzyszy zwiększenie metabolizmu oraz wysokie zapotrzebowanie na energię. Farmakoterapia może spowodować pogorszenie apetytu. Upośledzenie fizyczne lub/i umysłowe może zaburzyć spożywanie posiłków. Niedostateczna aktywność fizyczna jest przyczyną niskiego zapotrzebowania na energię, a tym samym powoduje trudności w uzyskaniu dostatecznego pokrycia zapotrzebowania na niezbędne składniki odżywcze. Nieodpowiednie otoczenie towarzyszące spożywaniu posiłków może być przyczyną niedostatecznego odżywienia. Niedożywienie może się zdarzyć także w przypadku złego stanu jamy ustnej oraz niedostatecznej wiedzy i zrozumienia problemów żywieniowych przez personel medyczny. W badaniach przeprowadzonych przez naszą grupę wykazano, że poprawa np. otoczenia towarzyszącego spożywaniu posiłków, a także wzbogacanie składnikami odżywczymi przyczynia się do poprawy stanu odżywienia tych pacjentów.
The aim of this study was to test the air in a single hospital department for fungal contamination. The department included three fully protected rooms with laminar air flow, comprising a bone marrow transplant unit (BMTU) and eleven naturally ventilated patient rooms of a haematology unit (HAEMU). Air samples were taken with an IDEAL air sampler (bioMerieux) on Sabouraud dextrose agar plates. The concentration of fungi in the air of the HEPA-filtered rooms of the BMTU ranged from 0-75 CFU/m3. Penicillium and Cladosporium were dominant among the fungal biota in the whole department. Of aspergilli, A. fumigatus was prevalent and seasonal increases in the frequencies of A. clavatus and A. niger isolation were observed. The detection of potentially pathogenic species of Aspergillus and Mucor in the BMTU and an increased concentration of Aspergillus in the HAEMU (up to 200 CFU/m3) instigated the introduction of additional preventive measure besides routine disinfection, namely an exchange of the HEPA filters in the BMTU and the installation of equipment based on multifunctional ion technology in the HAEMU. In a subsequent examination, a diminished number of fungi in the air was observed. During the study, 2 cases of proven and 3 of probable aspergillosis (according to EORT criteria) were noted. There was no link observed between the higher concentration of Aspergillus detected in the hospital air and the development of the infection. The authors conclude that hospital air examination can be helpful in indicating problems with hospital air facilities, enabling the introduction of procedures improving air quality and subsequently diminishing the risk of nosocomial mycoses.
Background. Prevalence of malnutrition among hospitalized patients is a common issue increasing the morbidity and mortality rate. In response to the aforementioned problem the European Society for Clinical Nutrition and Metabolism (ESPEN) stated an action plan to fight malnutrition and created in 2004 the global health project named NutritionDay (nD) - a single-day, population based, standardized, multinational cross-sectional audit which is performed worldwide in hospitals and nursing homes. Objectives. To present selected NutritionDay (nD) results from Poland describing the nutritional situation of hospitalized patients in 2006 – 2012 compared to other countries participating in nD study. Material and Methods. Data were collected in nD study through voluntary participation all over the world during seven years - from 2006 to 2012. Data collection was performed on ward level by staff members and patients using standardized questionnaires. The data were analyzed by the Vienna coordinating centre using the Structured Query Language (“my SQL”) - an open source relational database management system as well as the Statistical Analysis System version 9.2 (SAS). Results. In Poland 2,830 patients were included in the study during a 7-year survey, while 5,597 units recruited 103,920 patients in the world (nD reference). About 45% of the patients had a weight loss within the last 3 months prior to admission (same for nD references); 58.34% reported a decrease in eating during last week (54.85% in case of nD references). Food intake at nD illustrated that 60.55% of the patients ate half to nothing of the served meal (58.37% in the case of nD references). For both Poland and other countries participated in audit at the time of detection of malnutrition on the half of hospital wards wasn’t reported any action aimed at combating this phenomenon. Conclusions. Malnutrition of hospitalized patients in Poland was found comparable to the rest of the world. These results reflects the fact that malnutrition is a common issue among hospitalized patients all over the world and it would be recommended to continue the action plan to fight against malnutrition commenced by the European Society for Clinical Nutrition and Metabolism (ESPEN) on international and national level.
The genetic features of each isolate were determined by enterobacterial repetitive intergenic consensus (ERIC) primer sequences used in PCR and by searching for six virulence genes (alg D, las B, tox A, plc H,plc N, exo S). 49 (79%) of the isolates were distributed in three ERIC PCR subgroups and showed 62% of similarity. The remaining 13 strains generated unique patterns. The first subgroup was primarily composed of isolates from faeces, these strains indicated over 70% relationship with the next subgroup, and primarily contained strains isolated from wounds and bronchial washings and the last subgroup contained strains isolated from wounds and urine. The unique strains were isolated mainly from urine. Statistical analysis indicated that variations in distribution of virulence genes in P. aeruginosa isolates with respect to strain origin and genomic subgroups were not significant. In the group of 49 strains, 100% gave a positive reaction to alg D, las B and plc H genes, 91.8% to tox A and plc N genes and 83.7% to exo S gene. Among the strains that generated unique (ERIC-PCR) patterns, 69.2% gave a positive reaction to alg D gene, 84.6% to las B gene, 76.9% to tox A, plc N and plc H genes, and 46.15% to exo S gene.
A total of 100 non-duplicate Acinetobacter baumannii isolates were collected from different hospitals in Tehran and were confirmed as A. baumannii by conventional biochemical and API testing. Antimicrobial susceptibility of these isolates was checked by a disk diffusion method in accordance with CLSI guidelines. The isolates were then detected as carrying class 1 and 2 integron gene cassettes by PCR evaluation and then genotyped by REP-PCR. More than 50% (n = 50) of the isolates were multidrug resistant. The results showed that more than 80% of all multidrug resistant A. baumannii strains carry a class 1 integron. Distribution of IntI 1 and IntI2 among A. baumannii isolates was 58% and 14%, respectively. Analysis of a conserved segment of class 1 integron showed a range from 100 bp to 2.5 kb. REP-PCR fingerprinting showed more than 20 genotypes among A. baumannii strains. There was no relationship between REP genotypes and the distribution of different classes of integrons. This is a comprehensive study on the distribution of different classes of integrons among A. baumannii in Iran. Considering the exact role of integrons in coding drug resistance in bacteria, the findings of this study could help us find antimicrobial resistant mechanisms among A. baumannii isolates in Iran.
Praca przedstawia projekt koncepcyjny zagospodarowania terenu przy Samodzielnym Publicznym Szpitalu Klinicznym nr 4 w Lublinie. Podjęto próbę zdefiniowania pojęcia ogrodu terapeutycznego i określono funkcje, jakie powinny spełniać takie obiekty. W ramach prac terenowych wykonano inwentaryzację dendrologiczną i ogólną inwentaryzację terenu oraz analizy terenu opracowania. Przedstawiono koncepcję projektową wraz z ukształtowaniem terenu i doborem roślin. Zaproponowano całkowitą wymianę nawierzchni oraz elementów małej architektury. Na terenie atrium zaprojektowano siłownię zewnętrzną oraz zaproponowano zwiększenie użyteczności dachu budynku poprzez stworzenie na nim zielonej przestrzeni. Teren ma być miejscem wypoczynku i wspomagania rekonwalescencji.
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