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Surgical site infections in Slovenian acute care hospitals: Surveillance results, 2013–2016

Abstract

Introduction

The objective was to present the results of the Slovenian National surgical site infections (SSIs) surveillance system from 2013 to 2016 and to compare them to the reference data for the European Union (EU) and European Economic Area (EEA) countries.

Methods

Surveillance was conducted according to the Slovenian protocol consistent with the European Centre for Disease Prevention and Control protocol. Descriptive analyses were performed.

Results

Data were collected for 1080 patients of whom 57.4% were patients with cholecystectomy (from three hospitals), 29.0% with caesarean sections (from four hospitals) and 4.7%, 4.5% and 4.4% patients with hip prosthesis, knee prosthesis and colon surgery (each surgical category from one hospital). The pooled in-hospital SSI incidence density for caesarean section was 3.7 (95% CI: 1.4-8.1; inter-hospital range: 0.0–11.5) and for cholecystectomy 6.8 (95% CI: 3.5-11.9; inter-hospital range: 4.1–11.9) per 1000 post-operative patient-days. The in-hospital SSI incidence density for colon surgery was 24.8 (95% CI: 12.5-44.0) and for hip prosthesis 2.6 (95% CI: 0.1-14.2) per 1000 post-operative patient-days. No SSIs were reported among the 49 patients with knee prostheses.

Conclusions

The estimated SSIs incidence rates varied between different surgical categories and the different participating hospitals. In some of the participating hospitals and for some of the surgical procedures under surveillance they were rather high in comparison to the reference data for hospitals from EU/EEA countries. It is urgent to expand standardised SSIs surveillance to all Slovenian acute care hospitals with surgical wards to contribute to evidence-based SSIs prevention and control in Slovenia.

Open access
Validation of the Slovenian version of motor imagery questionnaire 3 (MIQ-3): Promising tool in modern comprehensive rehabilitation practice

Abstract

Purpose

The high rate of injury incidence and its severity is estimated to cause approximately 9% of global mortality, while a large proportion of people surviving their injuries experience temporary or permanent disabilities. To reduce the occurrence of disability and improve general health of survivors, a more comprehensive rehabilitation approach is needed. Motor imagery is recognized as the promising cognitive strategy to counteract impaired functional capacity of the neuromuscular system. Thus, we aimed to provide to the Slovenian-speaking community a valid and reliable version of Motor Imagery Questionnaire – 3 [MIQ-3], that consists of kinaesthetic imagery [KI] and visual [i.e., Internal Imagery [IMI] and external imagery [EVI]] items.

Methods

We investigated both absolute and relative test-retest repeatability; construct validity and internal consistency of the KI, IMI and EMI items of the Slovenian version of MIQ-3 in 86 healthy adult subjects.

Results

Results showed high to very high average intra-class correlation coefficient [ICC] for the visual items [ICC=0.89] and KI items [ICC=0.92], whilst the measure of absolute variability presented as coefficient of variation [CV%] ranged from 4.9% [EVI] to 6.7% [KI]. The internal consistency was satisfactory [Cronbach α=0.91 [KI] and 0.89]) for both visual items. Confirmatory analysis confirmed a two-factorial structure of MIQ-3.

Conclusion

Understanding the content of the questionnaire is of utmost importance to ensure its effectiveness in rehabilitation practice. The Slovenian translation of the MIQ-3 is culturally and linguistically equivalent to the original English version.

Open access
Work-Related stress factors in nurses at Slovenian hospitals – A cross-sectional study

Abstract

Background

Surveys conducted among healthcare workers revealed that nursing staff often face various stressors associated with occupational activities, which reduce their work efficiency. The aim of the study was to establish the level of stress in nurses working at hospitals in Slovenia and to identify stress-related factors.

Methods

A cross-sectional epidemiological design and a standardized instrument called the “Nursing stress scale” were used. The sample included 983 nurses from 21 Slovenian hospitals. The research was conducted in 2016.

Results

Prevalence of high level of stress was 56.5% of respondents (M (median)=75). Prevalence of high level of stress and stress factors may be statistically significant attributable to dissatisfaction at work (p<0.001), disturbing factors at work (p<0.001), inability to take time off in lieu after working on weekend (p=0.003), shorter serving (p=0.009), fixed-term work (p=0.007), and an increased number of workdays on Sunday (p=0.030).

Conclusion

The stress rate and stress factors are substantially influenced by variables reflecting work organization, competences and skills of healthcare management to work with people. Results reflect the need for nursing management and policy makers to design strategies to ensure adequate staffing, efficient organization and an encouraging work environment.

Open access
Accidents Caused by the Difference in Air Pressure Inside the Diving Apparatus and the Water Surrounding the Diver

Abstract

This paper describes 4 unfortunate accidents caused by the difference in pressure inside and outside the diver’s suit. The issues relate to diver crushing, caisson disease, too fast an ascent to the surface and hypoxia as a result of exhaustion of oxygen in the diving apparatus are explained. The mechanism of the diving injuries was analysed and methods of prevention of such incidents were suggested.

Open access
Description of the Adsorption Equilibrium with Consideration to the Decreasing Availability of Space in the Course of Mobile Adsorption of a Single Gas on a Homogenous Surface of Solid

Abstract

The subsequent stages of the process of formulation of the equation for gas adsorption on a homogenous surface of a solid adsorbent were presented based on the general expression for the canonical ensemble of the mobile single-component adsorption monolayer. The method of formulating the configuration integral of the proposed model was discussed in detail where the role both of the attraction and repulsion between adsorbed molecules was emphasised. The expression for the probability of finding a molecule in a specified point on a surface of an adsorbent was modified by determining its magnitude by the adsorbent concentration. The expression for the so-called effective surface of the adsorbent was obtained by adapting a two-dimensional analogue equation of state hard spheres – Van der Waals equation (2D-vdW) and Reis-Frisch-Lebowitz equation accordingly (2D-RFL). As a result, two new adsorption equations were formulated which differ in detail concerning the adsorbate-adsorbate repulsion. On each of these equations theoretical analysis was performed in terms of two-dimensional phase transformation. In both cases it was proved that the proposed solution allows for the presence of two-phase transformations of the first type which is the gas-liquid condensation and solidification liquid-solid. The verification of the given approach was supplemented by the description of the experimental data given in reference literature and by obtaining a very good correlation between the theory and experiment.

Open access
Diabetic Patients Who are Amateur Divers

Abstract

Diabetes is an “epidemic of the 21st century” and it is estimated that in 2011 6.7% of Poland’s population suffered from diabetes, one quarter of which was unaware of the disease. Such a high prevalence of diabetes mellitus results in an increasing number of physicians being confronted with the problem of qualifying patient with diabetes to partake in amateur sports, including diving. This publication presents the most important information concerning risk assessment, admission of diabetic patients to amateur diving and some proposed protocols of management before and during sport practice.

Open access
Modernisation of a Breathing Simulator Hoist. Part 1

Abstract

This article presents the process of modernisation of a car lift in order to adjust it to the function of a hoist for lifting the decompression chamber cover in a breathing simulator used in the Department of Underwater Work Technology of the Naval Academy in Gdynia.

Open access
Risk Management in Kitesurfing as a Basic Condition of Effective Learning and Safe Swimming

Abstract

This article discusses issues related to safety during kitesurfing (swimming on a board with a kite). The considerations are based on risk management procedures. These procedures can be described interchangeably as managing your own safety. Risk management allows you to minimize threats without sacrificing your planned sport goals. The authors first describe the procedures related to the identification of threats occurring in this discipline. Teaching and practicing kitesurfing involves overcoming a large number of threats. These threats can have both external and internal character. The next stage is risk analysis, understood as the product of negative events and the probability of their occurrence. Afterwards, we discuss the ways of dealing with the threat in the event of its occurrence. The last stage is the risk control (tracking) - whether new threats have emerged, or the level of risk has remained unchanged. The described methodical impacts can be labelled as education for safety.

Open access
Anticholinergic burden and most common anticholinergic-acting medicines in older general practice patients

Abstract

Introduction

Anticholinergic burden in older adults has been correlated with cognitive decline, delirium, dizziness and confusion, falls and hospitalisations. Nevertheless, anticholinergic-acting medications remain commonly prescribed in up to a third of older adults in primary care population. Our aim was to study the anticholinergic burden in older adults in Slovenian ambulatory setting and explore the most commonly involved medications which could be avoided by the physicians.

Methods

A cross-sectional study was conducted in 30 general practices in Slovenia as part of a larger trial. Data on prescribed medications were collected for randomly chosen adults of over 65 years of age visiting general practice, who were taking at least one regularly prescribed medication. Anticholinergic burden was calculated using Duran’s scale and Drug Burden Index.

Results

Altogether, 622 patients were included, 356 (57.2%) female, average age of 77.2 (±6.2), with an average of 5.6 medications. At least one anticholinergic medication was present in 78 (12.5 %) patients. More than half (N=41, 52.6%) of anticholinergic prescriptions were psychotropic medications. Most common individual medications were diazepam (N=10, 1.6%), quetiapine (N=9, 1.4%) and ranitidine (N=8, 1.3%).

Conclusions

Though the prevalence of anticholinergic medications was low compared to international research, the most commonly registered anticholinergic prescriptions were medications that should be avoided according to guidelines of elderly prescriptions. It would be probably clinically feasible to further decrease the anticholinergic burden of older adults in Slovenian primary care setting by avoiding or replacing these medications with safer alternatives.

Open access
Empathy and burnout in Slovenian family medicine doctors: The first presentation of jefferson scale of empathy results

Abstract

Background

Study aimed to assess the burnout prevalence and level of empathic attitude in family medicine doctors (FMDs) and its associations with demographic factors, working conditions and physician health, using the Jefferson Scale of Empathy – Health Professional version (JSE-HP).

Methods

Slovenian FMDs (n=316, response rate 56%) completed an online socio-demographic questionnaire, with questions on working conditions, physician health, and the Slovenian versions of the Maslach Burnout Inventory (MBI) and the JSE-HP. Univariate and multivariate analyses were used, applying linear regression to calculate associations between demographic variables, factors of empathy and burnout dimensions, P<0.05 was set as a limit of statistical significance.

Results

Of the 316 participants, aged 40±10.2 years, 57 (18%) were men. The FMDs achieved mean scores on the JSE-HP (JSEtot of 112.8±10.2 and on the MBI 27.8±11.6 for EE, 10.8±5.5 for D and 33.5±6.0 for PA. High burnout was reported in one dimension by 24.8% of participants, in two by 17.2%, and by 6% in all three dimensions. Multivariate analysis revealed a higher EE and D and lower PA in specialists as opposed to trainees. Higher EE was also identified in older physicians having longer work experience, working in a rural setting, dealing with more than 40 patients/day and having a chronic illness. The latter was also associated with higher JSEtot. JSEtot was negatively associated with D, while PA was positively associated with JSEtot and Perspective Taking.

Conclusion

The incidence of burnout warns both physicians and decision-makers against too heavy workload, especially in older professionals.

Open access