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  • Author: Joanna Gotlib x
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Abstract

Aim of the study. Starting on January 1, 2016, nurses and midwives (NM) acquire extending the professional powers. Assessing the reliability and validity of a questionnaire developed to evaluate the knowledge of and attitudes towards acquiring extending the professional powers of NM.

Material and methodology. Forty-two students, voluntary, anonymous, original questionnaire study, 11 questions (knowledge) and 32 statements (attitudes), the Likert scale.

Results. Cronbach’s alpha reliability coefficient (α>0.70). Assessment of validity: indirect estimation of theoretical validity by identifying an internal correlation on the scale. Assessment of differences between the students: Kruskal-Wallis test, α=0.05, 11 knowledge-related questions - the easiness: 0.52, the mean differentiating power of 0.21. Cronbach’s alpha: 0.671. The subscale 1 comprising 26 statements underwent a factor analysis with two variables. The structure of subscale 2 (6 items) is uniform. The comparative analysis of students does not show differences by their majors (Kruskal-Wallis test).

Conclusion.

  1. Assessment of reliability and validity of the questionnaire has demonstrated that it is a proper tool to evaluate attitudes towards extending professional powers of NM.
  2. Assessment of the questionnaire has confirmed that there is a need to modify the knowledge-related questions.
  3. The study should be continued among a greater number of NM that would be more diverse.

Abstract

Introduction. To work safely, knowledge of law is crucial for midwives who should be familiar with the midwife’s rights and duties as well as their professional responsibility. Aim. Assessment of knowledge of midwives about their professional responsibility. Material and methods. A total of 103 MA Midwifery students of the Medical University of Warsaw, including 55 working and 48 not working as midwives. A diagnostic poll, original anonymous questionnaire, 25 close-ended questions, 8 openended questions. Statistical analysis: STATISTICA 10.0, Mann-Whitney U test, p<0.05. Results. Seventy-one percent of the study participants had knowledge of the binding provisions of law and 83% considered this kind of knowledge as necessary in their professional activity. Twenty-four percent of the total did not know any legal regulations. Thirty percent was not familiar with the Nurses and Midwives Act. Only 52% of the study participants were knowledgeable about the legal protection of midwives and indicated the protection established for public officers. Forty-six percent of the total said that the Act on Professional Self-Government of Nurses and Midwives of July 1st, 2011 regulates the issue of self-governance. As many as 30 study participants knew that membership in the self-governing body of midwives is obligatory. Conclusions. Knowledge of nurses about professional responsibility under amended provisions of law is insufficient and does not improve with experience as a midwife. Due to the fact that new acts on professional responsibility of midwives were implemented in Poland beginning in January 1st, 2012, it is advisable to extend qualifications and knowledge of midwives in order to improve their knowledge of professional issues. Midwives should constantly update their knowledge of legal regulations on their profession

Abstract

Introduction. A contrast-enhanced CT examination can have negative health implications. It can spark both allergic and other adverse reactions.

Aim. The study aimed at analyzing the incidence of acute allergic reactions to Ultravist 370, used as a contrast medium in a CT examination.

Material and methods. The analysis of medical records that comprised 12295 patients who had undergone a CT examination. Women accounted for 50.7% of the study participants. Mean age of the patients was 62 years (min. 15; max. 92, SD=10.123). In the study, 6219 patients were examined without using a contrast medium and 6076 individuals underwent a contrast-enhanced CT examination. In the further analysis, Group 1 comprised of 15 patients from the contrastenhanced CT examination group who confirmed being allergic to a contrast medium after the CT examination and Group 2 comprised 49 persons who had reported being allergic to iodine before the CT examination.

Results. 15 patients (8 women and 7 men) developed an allergy to Ultravist 370 (contrast medium). An acute allergic reaction was most likely to happen in two groups of patients: between 31-40 and 51-60 years. Some 12 out of 15 patients had no contraindications for taking an iodine-based contrast medium. The most frequent allergic reactions to Ultravist 370 were rash and urticaria (15 patients). Five patients out of those who experienced adverse reactions reported two symptoms of allergy each while other patients reported one symptom only. Patients with mild symptoms of acute reaction to a contrast medium (15 patients) received pharmacotherapy recommended by a radiologist. Some 13 individuals received Solu-Medrol intravenously and 2 patients received Solu-Medrol intravenously and Fenicort intramuscularly.

Conclusions. 1. Using Ultravist 370 in patients is safe, since there is very low risk of adverse side effects caused by the application of this contrast medium. 2. In the present study, age, gender, and risk factors contributed to the development of acute allergic reactions. However, due to the small size of the study group, it is obvious that issues like the incidence of symptoms of discomfort or intolerance of the drug need further research. 3. Owing to the fact that essential biochemical tests had not been performed on a large group of patients, doctors referring patients to a CT examination should take care of their own safety by properly preparing themselves for this procedure. 4. It seems essential to develop and implement regular trainings for CT laboratory staff with reference to the following issues: the incidence and nature of acute adverse reactions to non-ionic contrast medium (Ultravist 370), as well as the procedures for dealing with side effects

Abstract

The article presents the role of government and non-government organisations in promoting knowledge on Alzheimer's disease in Poland and the European Union. There is a detailed analysis of the EU documents and non-government organisations in promoting knowledge on Alzheimer's disease in Germany, France and Holland. There is a discussion on the National Alzheimer's Plan on the basis of an example of introducing such a plan in Finland. Additionally, the rules of helping people suffering from Alzheimer's disease and their attendants in Poland are presented.

Abstract

Introduction. Initially, a transplant coordinator assisted in the process of removal and transplantation of organs. The most important rule in the Polish legislation is the Act of July 17th, 2009, amending the Act on removal, preservation, and transplantation of cells, tissues, and organs. Professional qualifications of a transplant coordinator are specified by the Regulation of the Minister of Health of December 4th, 2009 on detailed conditions of removal, preservation, and transplantation of cells, tissues, and organs. Aim. The study aimed to assess the knowledge of medical personnel about the function of a transplant coordinator with reference to the current Polish legislation. Material and methods. The study was conducted in April 2013 among 100 selected health professionals (25 physicians, 62 nurses, and 13 persons representing other medical professions) with the use of a questionnaire comprising 42 close-ended simple choice questions and one multiple-choice question. They were referring to various aspects associated with the legal axiology of transplantation, procedure of organ donation, and tasks of a donation coordinator, as well as one open-ended question about the age of respondents. Results. Statistically significant differences between the occupational groups were found in relation to questions about legal and medical aspects. As many as 21 nurses (34%), 26 physicians (92%), and 6 persons representing other medical professions (46%) (p<0.000) provided the correct answer to a question referring to determination of death, and 19 nurses (31%), 7 physicians (28%), and 5 persons representing other medical professions (p<0.021) answered correctly to a question about the key premise to determine brain death. Conclusions. 1. The knowledge of medical personnel about the function of a transplant coordinator and the legal provisions concerning brain death determination needs to be supplemented. 2. There is a need of constantly supplementing knowledge of medical personnel about the clinical aspects of transplantation

Abstract

Introduction. Although European healthcare systems differ from country to country, almost all are currently going through profound changes and are becoming increasingly complex. New tasks and growing social expectations towards healthcare build high expectations of medical professionals regarding their competences. Knowledge and skills allowing for choosing the safest and most efficient option for patient care are particularly welcome. The idea of Evidence-based Nursing Practice (EBP) combines the best available research evidence on the one hand and clinical expertise and patients’ expectations on the other, allowing for solving problems in making clinical decisions. EBP is a tool used for making clinical decisions in nursing care that helps to reduce the cost of healthcare by increasing efficiency and safety. Under the Directive 2013/55/EU European Federation of Nurses Associations developed qualifications framework that provides requirements for nursing training, with the ability to apply research evidence in clinical practice being one of its key elements. Despite the aforementioned recommendations, the actual implementation of EBP into clinical practice is hindered by various obstacles. In addition, the existing European resources enhancing EBP teaching for nursing students are very limited.

Summary. The EBP e-Toolkit Project is a response to high needs of the academic world and nursing practitioners, involving six institutions whose cooperation and expertise aim to ensure the development and implementation of high-quality learning tools tailored to the educational needs of modern nursing personnel. The six higher education institutions that jointly implement the aforementioned project involve: the University of Murcia (coordinating institution, Spain), Technological Educational Institute of Crete (Greece), University of Modena e Reggio Emilia (Italy), University of Ostrava (Czech Republic), Medical University of Warsaw (Poland), and Angela Boskin Faculty of Health Care (Slovenia).

Abstract

Introduction. An independent prescribing certain drugs, including issuing prescriptions, as well as an entitlement to refer patients for certain diagnostic tests, constitute the key competences of an advanced nurse/midwife practice.

Aim. To analyze knowledge and attitudes of departmental nurses (DN) towards extending professional powers of nurses and midwives.

Material and methods. The sample involved 23 DN (women: 100%) working in the Independent Public Children’s Teaching Hospital in Warsaw. The mean age was 49 years (mode and median: 50; min. 31, max. 61, SD=7.95). The mean of professional experience was 30 years (mode: 25, median: 30, min. 17, max. 40, SD=6.38). A voluntary and anonymous questionnaire with 10 questions referring to knowledge and 32 statements concerning attitudes evaluated in the Likert scale was conducted.

Results. Almost all DN knew that prescribing drugs is a right and not an obligation. Nearly half of the DN knew when the new regulations shall enter into force. DN believed that the new regulations shall improve patient care and increase patient’s comfort and access to services. DN concern about preparation of nurses and midwives for new competences.

Conclusions.

1. The study group’s level of knowledge about the new competences was insufficient and requires supplementing.

2. The attitudes of the study group towards the new competences were not unambiguous. It should, however, be noted that the study was conducted in a specialized children’s teaching hospital, where the application of the amended regulations is limited.

3. Although the nursing management staff supports the legislative changes, they object to the process of introducing them. This applies particularly to the necessity of an adequate preparation of nurses and midwives.

4. The study should be continued among a representative group of nurses with a similar level of education, professional experience, and place of work, with particular consideration of nurses working in the outpatient health care.

Abstract

Introduction. Since January 1st, 2016, particular groups of nurses and midwives in Poland are allowed to write prescriptions and refer patients to diagnostic procedures without doctors’ involvement.

Aim. The aim of the study was to assess what university students know about the changes that expanded the professional competencies of nurses and midwives.

Material and methods. The study group comprised of 535 students of three different universities. The group was 82% female and the mean age was 23 years (min.=19; max.=58, SD=4.780). Nursing students were the largest group among the study participants (177 individuals which meant 33% of the total), followed by Medicine students (145 individuals, 27% of all), Midwifery (107 persons, 20% of the total), and Public Health (100 persons, 19% of all). As many as 324 respondents (60%) had never participated in any medical law-related courses. A voluntary and anonymous survey containing 39 questions divided into 3 parts: 13 questions about knowledge, 26 statements concerning attitudes using a Likert scale, 8 demographic questions) was used. Obtaining an approval from the University’s Ethical Review Board was not required. Pearson’s chi-square test was used to compare frequency of the correct answers by students of every major. The Kruskal-Wallis rank test with a post-hoc analysis for multiple comparison of mean rank sums, STATISTICA version 12.5 (StatSoft, Inc.), licensed to MUW, α=0.05, were used to calculate the differences in summative points for correct answers.

Results. Nursing students were significantly more likely to choose the correct answers, unlike Medicine or Public Health students (p<0.001), as well as Midwifery students (p<0.002). The answers provided by the students of Medicine, Public Health, and Midwifery were relatively similar.

Conclusions. The knowledge of students of various Polish universities concerning the expansion of professional competencies of nurses and midwives was insufficient and needs to be urgently updated. Learning curricula to be modified not only for students of Nursing and Midwifery but also for other members of therapy team, e.g. physicians and pharmacists as well as specialists in public health.

Abstract

Introduction. Apart from the increasing popularity of modern information technologies and the development of e-learning methods used for teaching medicine and health sciences, there was a spike of interest in using modern computer techniques for checking students’ knowledge.

Aim. The aim of the study was to compare the opinions of students of Medical University of Warsaw about the examinations and final tests conducted using the e-exam ASK Systems platform, measured by their participation in this form of assessmen knowledge.

Material and methods. 148 students; group 1 comprised students participating in an e-exam (59 persons) and group 2 included students not participating in an e-exam (89 persons). A voluntary, anonymous questionnaire study, electronic questionnaire, 58 statements measured using the Likert scale. Questionnaire reliability assessment: analysis of internal consistency with Cronbach’s Alfa coefficient (α>0.70). Statistical analysis: STATISTICA 12.0 licensed to WMU, Mann-Whitney U test.

Results. Cronbach’s α coefficient for the scale amounted to 0.70. Members of group 1 were more likely to admit that students need to put in extra effort into participating in an e-exam (p<0.001) and that test results might be worse than in case of a regular exam (p<0.050). Group 1 significantly more often reported that the participation in an e-exam can cause additional examination stress (p<0.002) and makes cheating during exams more probable (p<0.003).

Conclusions. 1. An analysis of the questionnaire demonstrated that this tool is reliable and can be used in further studies. 2. The participation in an e-exam slightly influenced the opinions of students on this form of knowledge assessment, which may mean that the students’ expectations concerning e-exams were consistent with the actual course of the exam. Therefore, students do not need any special procedure to prepare for e-exams. 3. This was a pilot study and it needs to be continued among the same group of students before and after the e-exam.

Abstract

Introduction. Modern nursing practice requires Nursing students to expand their knowledge both in the field of specialized nursing and learning the basics of medicine, as based on scientific evidence. The dissemination of research activities in nursing and the development of the profession, knowledge and practice based on Evidence-based Nursing may contribute to the increase of the effectiveness and improving the quality of healthcare services. Nursing teaching curricula should include subjects related to Evidence-based Medicine, such as scientific research methodology or critical analysis of scientific literature.

Aim. The aim of the study was to analyze the knowledge and attitudes of nursing students towards Evidence-based Medicine (EBM) and Evidence-based Nursing Practice (EBNP).

Material and methods. Out of 127 Master’s degree students in Nursing at the Medical University of Warsaw (4 men), 72% work as a nurse. Mean age of the study group was 26.55 years (min. 22, max. 51, SD=7.52) with 63% of the students attending full-time studies, with 90% being students of the first year. Some 53% earned their bachelor’s degree in Nursing in 2013. A standardized Evidence – Based Practice Profile Questionnaire from University of South Australia, quantitative analysis of the study results.

Results. Nearly 30% of the respondents have never encountered EBM or EBNP during their time at the University (n=41). Most students intend to use relevant scientific literature in order to update their knowledge (n=68) and to upgrade their skills, so as to integrate EBNP into their everyday professional practice (n=67). Some 60% of the respondents deem scientific reports useful for their work (n=76) but nearly half of them regards clinical experience as more important than the results of scientific studies, when it comes to making the right decisions in their professional practice (n=56). Nearly a half of the studied group (n=66) have never heard about the term minimum clinically worthwhile effect and only one person declared the correct explanation systematic review (n=1). 42% declare reading published scientific studies once a month but nearly 30% have never referred scientific findings to their own diagnosis (n=41) and 40% have never assessed its methodological correctness (n=51).

Conclusions. 1. The educational programs in the framework of Nursing studies should be supplemented with subjects of EBM and EBNP, so as to expand the nursing students’ knowledge and let them reap the benefits of using the latest study results in their future professional practice. 2. The level of knowledge about the principles of assessment of reliability of scientific evidence was strongly insufficient and requires urgent supplementation of knowledge and skills of students in this area. 3. It is necessary for students to update their knowledge, particularly when it comes to using the latest scientific literature in everyday clinical practice and skills connected with critical analysis of scientific evidence.