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Nurse's activities from triage to hospitalitalization of patients with acute abdomen
No full textAkutni abdomen je naziv za skup različitih bolesti i stanja koji mogu životno ugroziti bolesnika. S obzirom na kliničku sliku akutnog abdomena kod kojeg dominira abdominalna bol praćenja ostalim simptomima (mučnina, povraćanje, povišena tjelesna temperatura i sl) potrebno je što prije postaviti radnu dijagnozu da bi se krenulo u liječenje.
Medicinska sestra trijaže ima zadatak da na vrijeme prepozna kliničku sliku akutnog abdomena, te adekvatno kategorizira bolesnika u kategoriju trijaže da bi mu se na vrijeme pružila potrebna medicinska pomoć. Prognoza samog ishoda kod bolesnika sa akutnim abdomenom direktno je povezana sa procjenom kategorije trijaže koju donosi medicinska sestra trijaže.Acute abdomen is the name for a set of different diseases and conditions that can threaten the patient's life. Considering the clinical picture of an acute abdomen dominated by abdominal pain followed by other symptoms (nausea, vomiting, elevated body temperature, etc.), it is necessary to establish a working diagnosis as soon as possible in order to start treatment.
The triage nurse has the task of recognizing the clinical picture of an acute abdomen in time, and adequately categorizing the patient into the triage category in order to provide him with the necessary medical assistance in a timely manner. The prognosis of the outcome in patients with acute abdomen is directly related to the assessment of the triage category made by the triage nurse
Nursing care for patients with aortic dissection
No full textIako neuobičajena, akutna disekcija aorte je rijedak, ali po život opasan poremećaj. Disekcija aorte nastaje zbog odvajanja slojeva aorte. Pukotina u sloju intime rezultira napredovanjem disekcije (bilo proksimalno ili retrogradno) uglavnom zbog ulaska krvi između intime i medija. Akutna disekcija aorte povezana je s vrlo visokom smrtnošću; većina umire čak i prije nego što stignu do zdravstvene ustanove. Nešto bolju prognozu imaju bolesnici s kroničnom disekcijom aorte (više od dva tjedna). Zdravstvena njega bolesnika s disekcijom aorte predstavlja izazovno područje u medicinskoj skrbi koje zahtijeva brzu dijagnostiku, hitnu kiruršku intervenciju i pažljivu postoperativnu njegu. Medicinske sestre imaju ključnu ulogu u pružanju sveobuhvatne skrbi bolesnika tijekom cijelog procesa liječenja. U fazi pripreme za operaciju, medicinska sestra educira bolesnike i obitelji, prati vitalne znakove, koordinira timski rad i osigurava potrebne resurse. Nakon operacija, medicinske sestre prate postoperativni oporavak, nadziru vitalne znakove, administriraju lijekove, promatraju ranu i pružaju emocionalnu podršku. Njihova uloga obuhvaća i edukaciju bolesnika o rehabilitaciji, prevenciji komplikacija i promjenama životnog stila. Kroz suradnju s multidisciplinarnim timom i pružanje individualne njege.Although uncommon, acute aortic dissection is a rare but life-threatening disorder. Aortic dissection occurs due to the separation of the layers of the aorta. A tear in the intimal layer results in the progression of the dissection (either proximal or retrograde) mainly due to the entry of blood between the intima and the media. Acute aortic dissection is associated with very high mortality; most die even before they reach a health facility. Patients with chronic aortic dissection (more than two weeks) have a somewhat better prognosis. Medical care of patients with aortic dissection is a challenging area in medical care that requires rapid diagnosis, immediate surgical intervention and careful postoperative care. Nurses play a key role in providing comprehensive patient care throughout the entire treatment process. In the preparation phase for surgery, the nurse educates patients and families, monitors vital signs, coordinates teamwork and provides necessary resources. After surgeries, nurses monitor postoperative recovery, monitor vital signs, administer medications, observe the wound, and provide emotional support. Their role includes educating patients about rehabilitation, prevention of complications and lifestyle changes. Through collaboration with a multidisciplinary team and providing individual care
Health care of a patient with meniere 's diseasee
No full textMeniereova bolest je stanje koje pogađa unutarnje uho i manifestira se kroz simptome poput vrtoglavice, postepenog gubitka sluha i tinitusa (šuma u uhu). Nažalost, ne postoji jednostavna dijagnostička pretraga za ovu bolest. Liječenje simptoma vrtoglavice i mučnine obično uključuje farmakoterapiju i dijetoterapiju. U težim slučajevima, vestibularni sustav se može kontrolirati lokalnom primjenom gentamicina ili putem kirurških zahvata. Incidencija ove bolesti najviša je između 20-te i 50-te godine života. Pacijenti doživljavaju iznenadne napade vrtoglavice koji mogu trajati do 24 sata, obično popraćeni mučninom ili povraćanjem. Uz to, mogu se pojaviti dodatni simptomi poput pojačanog znojenja, proljeva i osjećaja nesigurnosti pri održavanju ravnoteže. Tinitus ili zujanje i hučanje u uhu može biti prisutan kontinuirano ili se javlja povremeno i nije povezan s položajem tijela ili kretanjem. Nakon napada mnogi pacijenti osjećaju punoću ili pritisak u zahvaćenom uhu. Činjenica je da u polovice bolesnika ovaj problem pogađa samo jedno uho. U ranim fazama bolesti, simptomi se mogu povući između napada, a razdoblja bez simptoma mogu trajati više od godinu dana. No, kako bolest napreduje, oštećenje sluha postaje trajno i postupno se pogoršava, a tinitus može postati kroničan. Smatra se da je briga o zdravlju od iznimne važnosti kako bismo kontinuirano pratili stanje pacijenta, detektirali eventualna poboljšanja ili pogoršanja tijekom procesa liječenja. Ključno je prepoznati važnost terapije i razviti planove njege za pacijente koji pate od Menierove bolesti. Ovaj plan prvenstveno treba obuhvatiti dijagnoze, postaviti ciljeve, identificirati intervencije te osigurati edukaciju koja je potrebna tijekom, ali i nakon liječenja. Ključna uloga u pružanju njege leži u adekvatnoj komunikaciji medicinske sestre s pacijentom. Ovakav pristup smanjuje anksioznost pacijenta, poboljšava emocionalno stanje i potiče ga da aktivno sudjelovanje u procesu liječenja. Osim toga, ova vrsta komunikacije pruža pacijentu osjećaj sigurnosti, nadu za ozdravljenjem i potiče pozitivan stav prema samom sebi i okolini.Meniere's disease is a condition that affects the inner ear and presents symptoms such as dizziness, gradual hearing loss, and tinnitus (ringing in the ear). Unfortunately, there is no simple diagnostic test for this disease. Treatment of dizziness and nausea symptoms typically involves pharmacotherapy and diet therapy. In severe cases, the vestibular system can be controlled through the local application of gentamicin or surgical procedures. The highest incidence of this disease occurs between the ages of 20 and 50. Patients experience sudden dizzy spells that can last up to 24 hours, often accompanied by nausea and vomiting. Furthermore, additional symptoms such as increased sweating, diarrhea, and a feeling of instability when maintaining balance may occur. Tinnitus, or ringing and buzzing in the ear, can be present continuously or occur intermittently and is not related to body position or movement. After an attack, many patients feel fullness or pressure in the affected ear. It is a fact that in half of the patients, this problem affects only one ear. In the early stages of the disease, symptoms may subside between attacks, and symptom-free periods can last more than a year. However, as the disease progresses, hearing loss becomes permanent and gradually worsens, and tinnitus can become chronic. It is considered that healthcare is of paramount importance in order to continuously monitor the patient's condition, detect any improvements or worsening during the treatment process. It is crucial to recognize the importance of therapy and develop care plans for patients with Meniere's disease. This plan should primarily include diagnoses, set goals, identify interventions, and provide the necessary education during and after treatment. The key role in providing care lies in effective communication between the nurse and the patient. Such an approach reduces the patient's anxiety, improves their emotional state, and encourages active participation in the treatment process. Moreover, this type of communication provides the patient with a sense of security, hope for recovery, and fosters a positive attitude towards themselves and their environment
Nurse's activities in treating patients with ventricular arrhythmia
No full textVentrikularne aritmije su poremećaji ritma srca koji nastaju zbog poremećenog rada srčanog
provodnog sustava. U ventrikularne aritmije ubrajaju se ventrikularne ekstrasistole, ventrikularna
tahikardija i ventrikularna fibrilacija. Ventrikularne ekstrasistole (VES) najčešći su oblik aritmija, te se
mogu pojaviti i kod zdravih osoba. Ventrikularna tahikardija (VT) i ventrikularna fibrilacija (VF) mogu biti
uzrok iznenadne srčane smrti. Simptomi koji se pojavljuju kod oboljelih od ventrikularnih aritmija najčešće
su: palpitacije, slabost, nedostatak zraka, vrtoglavica, gubitak svijesti i stenokardija. U postavljanju
dijagnoze najvažniji je elektrokardiogram. Novija dostignuća tehnologije omogućila su prevenciju i
liječenje ventrikularnih aritmija odnosno prevenciju iznenadne smrti. U liječenju osim korištenja
antiaritmika i elektrokardioverzije pozitivan učinak ima i ugradnja implantabilnog kardioverter
defibrilatora te radiofrekventna ablacija. Medicinska sestra ima značajnu ulogu u sudjelovanju pri
dijagnostičkim i terapijskim postupcima. U Jedinici intenzivne koronarne skrbi odgovorna je za praćenje
bolesnikova stanja, rano uočavanje znakova i simptoma životno ugrožavajućih aritmija te poduzimanje
prvih hitnih intervencija koje spašavaju bolesnikov život. Također, njena zadaća je sudjelovanje u
reanimacijskim postupcima, defibrilaciji bolesnika, elektrokardioverziji te zbrinjavanju bolesnika prije i
nakon provedenih terapijskih postupaka kao što su ugradnja implantabilnog kardioverter defibrilatora i
radiofrekventne ablacije. U djelokrug rada medicinske sestre kod bolesnika s ventrikularnim aritmijama
spada i provođenje zdravstvene njege, provođenje sestrinskih intervencija u svrhu rješavanja bolesnikovih
problema i zdravstveni odgoj. Zdravstveni odgoj se kod bolesnika s ventrikularnim aritmijama svodi na
osposobljavanje bolesnika da prepozna aritmiju, uzima propisanu terapiju i stekne znanje i vještine za život
nakon ugradnje implatibilnog kardioverter defibrilatora.Ventricular arrhythmias are abnormal heart rhythms that occur due to a disturbance in the
cardiac conduction system. Ventricular arrhythmias include ventricular extrasystoles, ventricular
tachycardia and ventricular fibrillation. Ventricular extrasystoles (VES) are the most common form of
arrhythmias, and can even occur in healthy people. Ventricular tachycardia (VT) and ventricular fibrilation
(VF) can cause sudden cardiac death. Symptoms that are the most common in patients with ventricular
arrhytmias are palpitations, weakness, shortness of breath, dizziness, loss of consciousness and angina
pectoris. The electrocardiogram is the most important test method in establishing the diagnosis. New
technology developments have enabled the prevention and treatment of ventricular arrhythmias, that is, the
prevention of sudden death. In addition to treatment by antiarrhythmics and electrical cardioversion, a
positive impact in treatment is also seen with the implantation of cardioverter defibrillator and
radiofrequency ablation. The nursing role is significant in participating in diagnosis and therapeutic
procedures. In Cardiac Intensive Care Unit, she is responsible for continuous monitoring of the patients,
early detection of signs and symptoms of life-threatening arrhythmias, and undertaking emergency care
procedures that save the patient's life. Furhermore, the nurse is tasked to assist in resuscitation procedures,
patient defibrillation, electrical cardiovesion, and patient care before and after therapeutic procedures such
as the installation of a cardioverter defibrillator and radiofrequency ablation. The scope of a nurse's work
for patients with ventricular arrhythmias includes the enforcment of health care, conducting nursing
interventions to solve the patient's problems and health education. Health education for patients with
ventricular arrhythmias is based on training the patient to recognize the arrhythmia, take prescribed therapy,
and acquire knowledge and skills for life after the cardioverter defibrillator installation
Promotion of the pro-social behaviours during the Covid 19 pandemic
No full textPoznavanjem pozitivnih, negativnih i ometajućih osobnih i socijalnih čimbenika u prihvaćanju prosocijalnih mjera u sučeljavanju s Covid pandemijom moći će se bolje planirati javno-zdravstveni postupci.
Pozitivni učinci mjera bili su: rad s lokalnim zajednicama i dopiranje do različitih populacija smatra se instrumentalnim kada je riječ o motiviranju ljudi na cijepljenje. Pozitivni privatni uzori rađaju pozitivnije ponašanje, što rezultira prosocijalnim ponašanjem; suprotno vrijedi za negativne uzore
Negativni učinci mjera bili su infodemija i širenje lažnih panike i pogriješnih informacija
Ometajući čimbenici promocije prosocijalnog ponašanja bili su osim religiojskih vjerovanja i negativnih socijalnih uzora: prakticiranje nezdravstvenih obrasca ponašanja prije pandemije Covid-19 (konzumacija duhana, alkohola); niži stupanj obrazovanja/informiranosti pojedinca/roditelja; prisutnost psihičkih poremećaja (anksioznost, depresija; religijska vjerovanja koja mogu imati negativan utjecaj na odluke vezane za cijepljenje ukoliko cjepiva koji koriste sadrže embrinalne stanice dok s druge mogu imati pozitivni utjecaj na zaštitu mentalnog zdravlja tijekom socijalne izolacije i nepovjerenje u vladu, zdravstveni sustav ili određene političke opcije dovode do lošijeg pridržavanja prosocijalnih mjeraBy knowing the positive, negative and hindering personal and social factors in the acceptance of prosocial measures in the face of the Covid pandemic, it will be possible to better plan public health procedures.
The positive effects of the measures were: working with local communities and reaching out to different populations is considered instrumental when it comes to motivating people to get vaccinated. Positive private role models breed more positive behavior, which results in prosocial behavior; the opposite is true for negative role models
The negative effects of the measures were an infodemic and the spread of false panic and wrong information
In addition to religious beliefs and negative social role models, the factors hindering the promotion of prosocial behavior were: practicing unhealthy patterns of behavior before the Covid-19 pandemic (tobacco, alcohol consumption); lower level of education/information of the individual/parent; the presence of psychological disorders (anxiety, depression; religious beliefs that can have a negative impact on decisions related to vaccination if the vaccines they use contain embryonic cells, while on the other hand they can have a positive impact on the protection of mental health during social isolation and mistrust in the government, the health system or certain political options lead to worse adherence to prosocial measure
Eating disorders and obesity in infancy and earlychildhood.
No full textPoremećaji prehrane se obično asociraju uz populaciju adolescenata, iako se mogu manifestirati i kod pedijatrijske populacije u dojenačkoj dobi te ranom djetinjstvu. Glavni zadatak ovog rada je pružiti informacije o atipičnim poremećajima prehrane kod pedijatrijske populacije koje nije lako dijagnostički klasificirati u precizne kategorije. Poremećaji hranjenja koje je teško uklopiti u precizne kategorije su odbijanje hrane (food refusal), selektivna prehrana (picky eating), averzija prema hrani (food aversion) fobija na hranu (food phobia), funkcionalna disfagija, emocionalni poremećaj izbjegavanja hrane i dojenačka anoreksija (infantile anorexia). Potrebno je spomenuti i pica poremećaj, ruminaciju te javnozdravstveni problem pretilosti.
Opisana su glavna obilježja svake dijagnoze uz potencijalne intervencije i solucije za svaki navedeni poremećaj prehrane. Osim navedenog, naglasit će se važnost zdravstvenog odgoja i pravilne prehrane uz način na koji medicinska sestra u predškolskim ustanovama može dati svoj doprinos u prevenciji poremećaja prehrane.
Glavnu ulogu u prevenciji imaju upravo roditelji koji utječu na pojavnost poremećaja u prehrani uz ishod dođe li do razvoja istih. Osim formiranja djetetove ličnosti, razvijaju se prehrambene navike uz preference upravo po primjeru roditelja, a jednom usvojene obrasce iz doma je teško korigirati. Mediji, djetetovi vršnjaci, školski i predškolski sustav uz okolinu predstavljaju druge potencijalne utjecaje u djetetovom životu koji mogu potaknuti na promjenu ili učvršćivanje djetetovog stava o prehrani. Ovdje se ističe medicinska sestra kao pomoćnik uz pomoć zdravstvenog odgoja koji se može primijeniti i na roditeljeEating disorders are usually associated with the adolescent population, although they can also manifest in the pediatric population during infancy and early childhood. The main task of this paper is to provide information about atypical eating disorders in the pediatric population that are difficult to fit into precise categories. Eating disorders that are difficult to fit into existing diagnostic categories are food refusal, selective or picky eating, food aversion, food phobia, functional dysphagia, emotional food avoidance disorder and infantile anorexia. It is also necessary to acknowledge pica disorder, infantile rumination and the public health problem of obesity.
The main features of each diagnosis are described along with potential interventions and solutions for each eating disorder listed. In addition to the above, the importance of health education and proper nutrition will be emphasized, along with the way in which a nurse in preschool institutions can contribute to the prevention of eating disorders.
The main role in prevention is played by the parents, who influence the occurrence of eating disorders and the outcome if they develop. Along with the formation of the child's personality, eating habits and preferences are developed precisely by following parents' example and once learned patterns from home are difficult to correct. The media, child's peers, school and preschool education systems along with the environment represent other potential influences in the child's life that can encourage a change or strengthening of the child's attitude about nutrition. This is the point where the nurse stands out as an assistant with the help of health education that can also be applied to parents
Experience of University hospital for tumors, Sestre milosrdnice University hospital Center in neoadjuvant short-course radiotherapy for rectal cancer: retrospective study
No full textKarcinom rektuma je bolest u kojoj se maligne stanice stvaraju u epitelu rektuma. Simptomi karcinoma rektuma su promjene u navici pražnjenja crijeva ili krv u stolici. Isti je izlječiv, osobito ako se rano otkrije. Pacijenti prolaze kroz liječenje koje uključuje operaciju, kemoterapiju i radioterapiju. Radioterapija koristi izvore energije, poput X-zraka, za ubijanje stanica raka. Ovaj oblik terapije se često kombinira s kemoterapijom čime se povećava vjerojatnost da će stanice raka biti uništene. Onkološko liječenje se može indicirati nakon operacije, s ciljem ubijanja moguće zaostalih zloćudnih stanica ili prije operacije kako bi se smanjila veličina karcinoma te tako omogućilo lakše kirurško uklanjanje.
„Short-course“ radioterapija (SCRT) je neoadjuvantni oblik liječenja resektabilnog karcinoma rektuma koji se sastoji od 5 frakcija zračenja po 5 Gy isporučenih tijekom 5 dana te operacijom obavljenom narednog tjedna. Nedavno kliničko ispitivanje RAPIDO je uspostavilo neoadjuvantnu short course radioterapiju praćenu kemoterapijom kao poželjnu opciju za pacijente s lokoregionalno uznapredovalim resektabilnim karcinomom rektuma kao novi standard liječenja.
U prošlosti je dugotrajno preživljenje bilo neuobičajeno za osobe s rakom rektuma, čak i nakon opsežnog liječenja. Zahvaljujući napretku u liječenju u posljednjih nekoliko desetljeća, stope preživljenja od rektalnog karcinoma znatno su se poboljšale.Rectal cancer is a disease in which malignant cells form in the epithelium of the rectum. Symptoms of rectal cancer are changes in bowel habits or blood in stool. It is curable, especially if detected early. Patients undergo treatment that includes surgery, chemotherapy and radiotherapy. Radiotherapy uses energy sources, such as X-rays, to kill cancer cells. This form of therapy is usually combined with chemotherapy, which increases the possibility of destroying cancer cells. Oncological treatment can be indicated after surgery with the aim of killing possibly residual malignant cells, or before surgery to reduce the size of the cancer and thus enable easier surgical removal.
Short-course radiotherapy (SCRT) is a neoadjuvant form of treatment for resectable cancer consisting of five radiation fractions of five Grays delivered over five days and surgery performed the following week. The recent RAPIDO clinical trial established neoadjuvant SCRT and chemotherapy as the preffered option for patients with locoregionally advanced resectable cancer as the new standard of care.
In the past, long-term survival was uncommon for people with rectal cancer, even after extensive treatment. Thanks to advances in treatment over the last few decades, survival rates from rectal cancer have improved significantly
Nursing care of patients with acute kidney injury
No full textAkutno bubrežno zatajenje je stanje koje je najčešće reverzibilno, a karakterizira se naglim padom
glomerularne filtracije u razdoblju od nekoliko sati do nekoliko dana. Postavljanje dijagnoze temelji se na
kriterijima koji uključuju procjenu kreatinina, količine izlučenog urina i brzine glomerularne filtracije.
Liječenje i zdravstvena njega bolesnika s akutnim bubrežnim zatajenjem temelji se na individualiziranom
pristupu i izradi individualiziranog plana zdravstvene njege kako bi se zadovoljile specifične potrebe
bolesnika. Ovaj pristup omogućuje pružanje personalizirane, sveobuhvatne i cjelovite zdravstvene njege
koja bolje odgovara jedinstvenim potrebama, mogućnostima, snagama i ciljevima bolesnika. Planovi
zdravstvene njege sadrže formiranu sestrinsku dijagnozu (na temelju prikupljenih podataka), postavljene
ciljeve te intervencije koje su usmjerene na postizanje istih.Acute renal failure is a condition that is most often reversible, and is characterized by a sudden drop in
glomerular filtration over a period of several hours to several days. Diagnosis is based on criteria that
include creatinine, urine output, and glomerular filtration rate. The treatment and health care of patients
with acute renal failure is based on an individualized approach and the creation of an individualized health
care plan to meet the specific needs of the patient. This approach enables the provision of personalized,
comprehensive and comprehensive health care that is better suited to the unique needs, capabilities,
strengths and goals of the patient. Health care plans contain a formed nursing diagnosis (based on collected
data), set goals and interventions aimed at achieving the
Population's awareness of stroke risk factors
No full textMoždani udar je naglo nastalo neurološko zbivanje koje je posljedica poremećaja moždane cirkulacije uzrokovano različitim čimbenicima, a jedan je od najčešćih uzroka smrti.
Prema zadnjim podacima svjetske zdravstvene organizacije godišnje od moždanog udara oboli oko 15 milijuna ljudi na svijetu. Oko 4,5 milijuna ljudi premine odmah ili nakon nekog vremena od posljedica moždanog udara. Oko pet milijuna ljudi ima trajne posljedice – zaostalu invalidnost.
Cilj ovog istraživanja bio je ispitati stupanj informiranosti populacije o rizičnim čimbenicima moždanog udara. Informiranost populacije o rizičnim čimbenicima je važna zbog što učinkovitijeg i uspješnijeg planiranja dodatnih edukativnih sadržaja s ciljem što bolje prevencije moždanog udara. Istraživanje je provedeno na području grada Splita i okolice od početka lipnja do kraja kolovoza 2023. godine. U ispitivanju je sudjelovalo 228 ispitanika u dobi od 18 do 72 godine. Rezultati istraživanja su pokazali dobru informiranost populacije o rizičnim čimbenicima. Vjerujemo da dobru informiranost populacije možemo zahvaliti današnjoj lakoj dostupnosti informacija kao i postojanju brojnih kampanja na temu popularizacije, prevencije i liječenja moždanog udara Dobra informiranost o rizičnim čimbenicima moždanog udara iznimno je važna jer omogućava ljudima da svojim odlukama i promjenom stila življenja značajno smanje rizik od moždanog udara.A stroke is a sudden neurological event caused by disruptions in brain circulation due to various factors and is one of the leading causes of death. According to the latest data from the World Health Organization, approximately 15 million people worldwide suffer from a stroke each year. Around 4.5 million people die immediately or shortly after a stroke, while about five million people are left with permanent disabilities as a result.
The aim of this research was to assess the level of public awareness regarding the risk factors for stroke. Public awareness of these risk factors is crucial for more effective planning of additional educational content aimed at better stroke prevention.
The research was conducted in the city of Split and its surroundings from the beginning of June to the end of August 2023. A total of 228 participants aged 18 to 72 took part in the study. The research results indicated a good level of public awareness about the risk factors. We believe that the population's good awareness can be attributed to the easy access to information today, as well as the presence of numerous campaigns focused on popularizing, preventing, and treating strokes. Good awareness of the risk factors for stroke is extremely important as it enables people to significantly reduce their risk of experiencing a stroke through their decisions and lifestyle changes
Nursing role in laboratory preanalysis-patient preparation and blood sampling
No full textCilj: Istražiti koliko medicinske sestre u KBC-u Split poznaju predanalitičke pogreške i čimbenike koji
utječu na predanalitičku fazu rada te u kojoj mjeri poznaju i primjenjuju smjernice za uzorkovanje venske
krvi.
Metode: Za potrebe ovog istraživanja sastavljen je anonimni anketni upitnik prema „Nacionalnim
preporukama za uzorkovanje venske krvi”. Upitnik se sastojao od 30 pitanja. Podijeljeno je 1000 upitnika,
od kojih su 642 vraćena ispunjena. Obrada podataka izvršena je u programu za tablično računanje
Microsoft Excel i IBM SPSS Statistics 25.
Rezultati: Rezultati ovog istraživanja pokazuju da se polovina ispitanika s pojmom predanalitičke
pogreške susrela u praksi, dok se samo 30% ispitanika s tim pojmom susrelo tijekom školovanja. Većina
ispitanika smatra da predanalitičke pogreške utječu na ishod laboratorijskog testiranja iako svega 12%
ispitanika zna da se u predanalitičkoj fazi rada događa 46-68% pogrešaka u laboratorijskom ciklusu
testiranja.Većina ispitanika pridržava se smjernica prilikom identifikacije bolesnika i obilježavanja
uzoraka, no neprihvatljiva je praksa koju navodi 7% ispitanika da ne identificiraju bolesnika jer ga
poznaju, kao i praksa naknadnog obilježavanja uzoraka koju navodi 5% ispitanika. 91% ispitanika zna da
je potrebno poštovati redoslijed epruveta s različitim aditivima, no gotovo jednaki broj ispitanika ne zna
točno odrediti redoslijed istih. Samo 4% ispitanika zna da se pri uzorkovanju krvi za neke analize ne
smije primijeniti podveza, a 38% ispitanika pogrešno primjenjuje podvezu otpuštajući je tek po završetku
uzorkovanja. Pogrešnu praksu pretakanja krvi iz epruvete u epruvetu u određenim situacijama koristi
četvrtina ispitanika, dok samo 32% ispitanika nikada ne uzorkuje krv u špricu. Učestalost nepoželjne
prakse smanjuje se s godinama radnog iskustva i višim stupnjem obrazovanja.
Zaključci:Iako je većina ispitanika svjesna činjeniceda predanalitičke pogreške utječu na ishod
laboratorijskih analiza te da su tehnika uzorkovanja i pravilan izbor pribora za uzorkovanje ključni za
dobivanje kvalitetnog uzorka za analizu značajno se podcjenjuje broj pogrešaka u ovoj fazi rada. Razina
znanja medicinskih sestara/tehničara o pojedinim koracima u postupku uzorkovanja krvi nije bila na
zadovoljavajućoj razini. Dobiveni rezultati u skladu su s većinom istraživanja koja su do sada provedena
o znanju medicinskih sestara/tehničara o predanalitičkim pogreškama i čimbenicima koji utječu na
predanalitičku fazu rada i kvalitetu uzorka.Rezultati ove studije pokazuju da je nužna kontinuirana
edukacija osoblja koje vrši uzorkovanje venske krvi. Medicinske sestre/tehničari iskazali su visoku
motiviranost za edukaciju u ovom području.Objective: To investigate knowledge of nurses at KBC Split about pre-analytical errors and factors that
affect the pre-analytical phase of work and to what extent they apply the guidelines for venous blood
sampling.
Methods: For the purposes of this research, an anonymous questionnaire was compiled according to the
"National Recommendations for Venous Blood Sampling". The questionnaire consisted of 30 questions. A
questionnaire was completed by 642 nurses. Data processing was performed in the Microsoft Excel and
IBM SPSS Statistics 25.
Results: According to theresults half of the respondents encountered the concept of pre-analytical error in
practice, and only 30% during their education. Most respondents believe that pre-analytical errors affect
the outcome of laboratory testing, although only 12% know that 46-68% of errors in the laboratory test
cycle occur in the pre-analytical phase of work. Most respondents adhere to the recommendations when
identifying patients and labelling samples, but 7% respondedthatthey do
notidentfypatientsbecausetheyknowthemwhichisunaccetable practice, as wellas practice of subsequent
tube labelling (5%). 91% of respondents know that it is necessary to respect the order of draw, but almost
the same number do not know recommended order. Only 4% of respondents know that tourniquet should
not be used for sampling of blood for some analyses, and 38% remove tourniquet after filling the last tube.
One quarter of respondents use unacceptable practice of transferring blood from one test tube to another,
and only 32% of respondents never use syringe for sampling. The incidence of undesirable practices
decreases with working experience and higher level of education.
Conclusions:Althoughmost respondents are aware of the fact that pre-analytical errors affect the results
of laboratory analyses, and that sampling techniques and quality of materials used for sampling are
prerequisite for good sample quality, they significantly underestimate the number of errors at this stage.
The level of knowledge of nurses/technicians in some steps of blood sampling was not satisfactory. The
results of the research are consistent with most of the research conducted so far regarding the knowledge
of nurses/technicians about pre-analytical errors and factors that affect the pre-analytical phase of work.
The results of this research show that it is necessary to continuously educate staff on blood sampling.
Nurses/technicians have shown high motivation for education in this area