Agata Reczek

Zdarzenia niepożądane w praktyce zawodowej pielęgniarek pracujących na oddziale anestezjologii i intensywnej terapii

Wstep. Celem wspolczesnych systemow ochrony zdrowia jest zapewnienie wysokiej jakości świadczonych uslug medycznych, w tym bezpieczenstwa pacjenta. Anestezjologia i intensywna terapia ze wzgledu na swoją specyfike zwiekszają ryzyko wystąpienia roznego rodzaju zagrozen, w tym zdarzen niepoządanych. Cel pracy. Analiza wystepowania zdarzen niepoządanych w praktyce zawodowej pielegniarek pracujących na oddziale anestezjologii i intensywnej terapii, poznanie ich czestości i przyczyn. Material i metody. Badania przeprowadzono wśrod 83 pielegniarek/pielegniarzy pracujących na oddzialach anestezjologii i intensywnej terapii. Wiekszośc badanych stanowily kobiety (96,4%). Średnia wieku wynosila 35,6 roku (SD = 8,2). W badaniach wykorzystano autorski kwestionariusz ankiety stworzony na podstawie analizy literatury i narzedzia badawczego: Hospital Survey on Patient Safety Culture. Wyniki i wnioski. Wystąpienie zdarzenia niepoządanego w trakcie wykonywania czynności zawodowych zadeklarowalo 32,5% badanych — istotnie cześciej ci, ktorzy liczbe zatrudnionych pielegniarek uznali za niewystarczającą (p = 0,018) oraz bedący zdania, ze praca w godzinach nocnych stwarza ryzyko zdarzenia niepoządanego (p = 0,022). Spośrod deklarujących wystąpienie zdarzenia niepoządnego 51,9% nie zglosilo tego faktu przelozonym. Najczestszym zdarzeniem niepoządanych bylo przypadkowe usuniecie rurki intubacyjnej, sondy zolądkowej (68,7%). Sformulowano nastepujące wnioski: 1. Co trzeci badany zadeklarowal wystąpienie zdarzenia niepoządanego w trakcie wykonywania pracy. 2) Zdecydowana wiekszośc badanych raportowanie zdarzen niepoządanych uwazala za obowiązek kazdego pracownika, tymczasem tylko polowa spośrod tych, ktorzy zadeklarowali jego wystąpienie w trakcie wykonywania pracy, zglosila ten fakt przelozonym. 3) Czestośc wystepowania zdarzen niepoządanych zalezala od opinii badanych na temat warunkow pracy; nie mialy na nią wplywu cechy socjodemograficzne.

Przygotowanie pacjenta po implantacji kardiowertera-defibrylatora do samoopieki

Pacjentom zagrozonym naglym zgonem sercowym coraz cześciej implantuje sie kardiowertery-defibrylatory. Są to urządzenia programowane, wplywające na rytm serca. Najwazniejszym rodzajem terapii tych urządzen jest terapia wysokoenergetyczna. Pacjenci po implantacji kardiowertera-defibrylatora wymagają objecia specjalistyczną opieką, okresowej kontroli urządzenia, jak rowniez wsparcia i przygotowania do samoopieki. Celem pracy bylo przedstawienie wybranych aspektow dotyczących funkcjonowania w codziennym zyciu, z ktorymi powinien byc zapoznany pacjent po implantacji kardiowertera-defibrylatora. Wśrod nich wyodrebniono: obserwacje miejsca implantacji, aktywnośc fizyczną i sport, napady arytmii i interwencje kardiowertera-defibrylatora, oddzialywanie urządzen elektrycznych i magnetycznych na prace implantowanego urządzenia, podrozowanie i prowadzenie pojazdow oraz kontrole w poradni specjalistycznej.

Opieka pielęgniarska nad pacjentką z ostrym zespołem wieńcowym po przezskórnej interwencji wieńcowej

Introduction: Acute coronary syndrome (ACS) is due to acute ischaemia of the cardiac muscle, which results from a sudden obstruction of the blood flow in the coronary circulation. A life-threatening condition, it is one of the most common causes of illness and death. Objectives: To present the ACS patients health condition, nursing diagnoses and actions, and the results of nursing care of the patient following percutaneous coronary intervention (PCI) during hospitalization. Material and methods: The study involved a female patient with acute coronary syndrome following primary PCI. The individual case study method was used. Results and conclusions: Having analyzed the patients health condition, a number of nursing diagnoses were made. These included the patients weakness, pain in the upper limb, the feeling of numbness, cooling, hand oedema as a result of applying a pressure dressing; difficulty breathing due to obstruction in the pulmonary circulation; urine retention resulting in pain; impaired carbohydrate metabolism; restricted physical activity and self-care deficiency; the patients insufficient knowledge concerning necessary changes in the lifestyle following acute coronary syndrome. Potential nursing diagnoses included the risk of occurrence of ventricular arrhythmia, bleeding complications and renal dysfunction. Then the aims of nursing care were established, the performed nursing actions were presented and their results assessed. The patients condition was stable; there were no complications and the patient was prepared to live following acute coronary syndrome.

Wybrane czynniki psychospołeczne a zachowania zdrowotne młodzieży licealnej. Część III. Poczucie umiejscowienia kontroli zdrowia a prezentowane zachowania profilaktyczne.

Introduction. Personal health locus control is related to health behavior presented by adult people. Persons with the internal health locus control, take greater responsibility for maintaining and improving their own health in comparison with people with the external health locus control pattern. It is anticipated that the internal health locus control might influence older adolescents to perform pro- health behaviors as well. Goal. To verify if there is a correlation between the health locus control and selected preventive behavior patterns presented by high school students. Materials and methods. The study was conducted in a group of 1036 students (688 girls and 348 boys) aged 16-19 years. The Multidimensional Health Locus Control Scale (MHLC) and the Health Behavior Inventory (Preventive Behaviors) were used. Results.In the study group, the mean value of the internal health locus control (24.51 points) was higher than two others: 18.18 points for the influence of other people and 17.94 points for the impact of the event. The influence of other people was stronger among 16 year olds (18.61 points) than in older student groups. In the group of 17-year-old students the importance of internal control (26.69 points) was the strongest. Concerning presented preventive behavior patterns the studied group of adolescents received an average score of 18.36 points; the value for women (18.62 points) was statistically higher than for men (17.85 points), p=0.023. The linear regression analysis proved a significant correlation between student preventive behaviors and the internal health locus control (p = 0.000000, r2 = 0.20), as well as with the influence of other people (p = 0.000000; r2 = 0.26). Conclusions.1 /. In high school students the internal health locus control and the influence of others (especially among 16-year-olds) are correlated with health behaviors presented by young people. 2 / These results indicate a need for targeted interventions aiming to increase the internal health locus control in assuming the increasing responsibility of high school students for their own health behavior.

Częstość występowania komponentów zespołu metabolicznego wśród 18-letniej młodzieży — ocena zmian w okresie rocznej obserwacji

Introduction. The results of recent studies indicate an increase occurrence of components of metabolic syndrome (MS) in adults as well as in children and adolescents. Limited data are available concerning prevalence of MS components among young adults, or studies showing the direction of changes in these risk factors in the final stage of adolescence. Objective. To assess the occurrence of components of MS and their changes within a one-year observation period in a group of youth graduating from a secondary school. Material and methods. The study was carried out twice, with a 12-month interval, among 141 secondary school students aged 17–19. The study involved the measurements of waist circumference and blood pressure (BP) as well as concentrations of HDL-cholesterol (HDL-C), triglycerides (TG) and venous blood glucose. The results were assessed on the basis of the International Diabetes Federation (IDF) criteria from the year 2007. In the statistical analyses the value of p < 0.05 was set as the significance level. Results. Within a 12 months observation period, a significant increase in the number of individuals whose waist circumference fulfilled the criteria of MS diagnosing; in entire group (p = 0.004) and in women (p = 0.009). The occurrence of elevated values of BP increased significantly in the assessed group (p < 0.001) and in men (p < 0.001). After a year a significant increase in the mean values was observed concerning waist circumference (p < 0.001) and systolic blood pressure (SBP) (p < 0.001), both in women (p < 0.001 and p < 0.001) and in men (p < 0.001 and p < 0.001). An increase in TG concentration (p = 0.016) was registered among studied men. Conclusions. The significant increase in the occurrence of components of MS observed within 12 months across the assessed youth reveals a need to identify and monitor these changes in order to undertake effective actions for health promotion. Nursing Topics 2015; 23 (4): 458–464

Czynniki wpływające na honorowe oddawanie krwi przez krwiodawców na Podkarpaciu

Introduction. Public service is an integral part of the blood of Polish health care system. Regional Blood Center in Rzeszow is one of the public entities blood in Poland obliged to protect the blood and its components in Podkarpacie, and also authorized for distribution in this area throughout the country. The aim of the study. Understanding the factors that influence the unpaid blood donor blood through the Subcarpathia region. Material and methods. The study involved 214 donors from Subcarpathia region. Authoring tool was a questionnaire containing questions on socio-demographic data with regard to questions about the status of the Blood Donor, as well as the questions focused on determinants that may influence the decision about blood donation. Results. Most respondents were multiple blood donors (N = 167; 78.0%). First time donors accounted for 1/5 of respondents. The most frequently mentioned reason donate blood for the first time was a desire to help others (N = 146; 68.2%). Nearly 1/5 (N = 42) said that donating blood guided by the ability to perform basic research and medical consultation. Just for 3.7% of patients (N = 8) to make a decision about blood donation and blood donation frequency influenced able to benefit from relief of purchase free of drugs. Conclusions. Established by law privileges for blood donors by blood donor used, but they are not major boost determining their decision, and only encouraging factor, or offsetting. Nursing Topics 2015; 23 (4): 477–483