ОЦЕНКА ДЕЯТЕЛЬНОСТИ СРЕДНЕГО МЕДИЦИНСКОГО ПЕРСОНАЛА ГЕРИАТРИЧЕСКИМИ ПАЦИЕНТАМИ
Паскалева Д. А.1, Туфкова С. Г.2
1Кафедра "Сестринского ухода", Факультет общественного здоровья, МУ Пловдив, 2Вторая терапевтическая кафедра, отделение Токсикологии, МУ Пловдив
ОЦЕНКА ДЕЯТЕЛЬНОСТИ СРЕДНЕГО МЕДИЦИНСКОГО ПЕРСОНАЛА ГЕРИАТРИЧЕСКИМИ ПАЦИЕНТАМИ
Аннотация
Оценка гериатрических пациентов о деятельности среднего медицинского персонала может быть использована для повышения качества сестринских уходов в больничных отделениях. Целью данного исследования является установление мнения гериатрических пациентов о полученных медицинских и здравных уходов в стационаре. В обследование были включены респонденты поступившие на лечение в стационарные отделения университетских больниц города Пловдива. Результаты показали, что пациенты удовлетворены оказанным им уходом и деятельностью среднего медицинского персонала.
Ключевые слова: гериатрические пациенты, здравный уход.
Paskaleva D.A.1, Tufkova S.G.2
1Department of Nursing care, Faculty of Public Health, MU – Plovdiv, 2Second Internal department, Toxicology section, MU – Plovdiv
ASSESSING THE ACTIVITIES OF THE NURSES IN INPATIENT SETTINGS THROUGH THE EYES OF GERIATRIC PATIENTS
Abstract
Geriatric patients’ evaluation for the activities of the nurses could be used for improving the quality of nursing case in the different hospital wards. The purpose of the survey is to ascertain geriatric patients’ opinion for the provided health care in the inpatient settings. In this survey were included respondents that were admitted for a treatment into the inpatient wards of the Plovdiv’s University hospitals.The results show that the patients are satisfied with the already provided nursing activities and health care.
Key words: geriatric patients, heath care.
In order to attract the patient as an active participant in the healing process, he have to be prepared with the structure of the ward, behavior and course of the ongoing tests and manipulations. The role of the nurse is not only to carry out these activities, but in the most appropriate and affordable way to explain the patients about their upcoming medical and therapeutic procedures [1].
The quality of the provided medical services mostly depends on the qualification of the medical staff [2, 3, 4, 5].
According to ordinance 1 from 8.02.2011, one of the basic professional activities that nurses can perform by themselves or after they were asked by a doctor, is to provide and collect health information [6].
This activity includes a wide range of duties:
- Acquainting the patient with the structure, organization and work schedule of the hospital;
- Acquainting the patient with the promotion activities, prevention, diagnosis, treatment or rehabilitation, which are carried out by the hospitals;
- Informing the patient in order to obtain informed consent in conducting research and manipulations;
- Keeping and updating the medical records;
- Preparation of the required reports and analyzes, related to the activities;
- Giving instructions to the patient when it’s needed to take material for medical and biological analyzes;
- Keeping tracks and recording laboratory tests, manipulations and health care;
After the review of a literature related to the hospital services, M. Popov’s, B, Davidov’s and M. Marinov’s research team concludes that “the patient is a specific subject with its own specific needs, rights, feelings, satisfactions and dissatisfactions” [7].
For that reason, we have decided to research the opinion of the geriatric patients for the provided health care in the inpatient settings.
We have surveyed 313 patients with age range 50-80 years which were admitted for treatment in the inpatient wards (surgical, internal and intensive ) of the University Hospitals of Plovdiv.
After the statistical processing of the data, the following results were delivered, and on their base we have brought discussions.
Among the respondents the largest is the proportion of the people with age range 61-70 years, followed by those with 71-80 age range (fig. 1).
Fig. 1 - Division according to the age of the surveyed patients
From the obtained results is pretty clear that most of the patients (73.8 %) are receiving enough information about their medical condition. Not a small percentage, however, are those which are unhappy with the amount of received information (14, 4 %). The nurses should provide this information within their competency, in accessible language and in value that is enough to help the patient with his decision. The information that is served correctly from health specialists is helping the patient to create one feeling of trust, to overcome his fear and anxiety from the disease (fig. 2).
Fig. 2 - Patients’ satisfaction from the received information
Most of the patients convictional are claiming that the nurses spare enough time for the medical manipulations (82%). One part of the patients (7, 35 %) are not happy and answered negative or with “not always” (fig. 3).
Fig. 3 - Patients’ opinion about the nursing manipulations
The effective pain assessment is absolutely necessary for a proper planning of the activities, and proper behavior that the nurse should have. In the evaluation process it’s needed to obtain information from the patient (or from his relatives), which helps her to understand his feelings better. The already received information is necessary for planning and evaluation of the strategies for assisting respectively the pain syndrome to be controlled timely.
In this research we have found that the majority of patients’ (67,4 ± 2,65%) pain syndrome has been contained timely. One-fifth of the respondents gave a negative answer [26,8 ± 2,50%].(fig.4)
Fig.4 - Overcoming of the pain process to the patients
We believe that these results are pretty disturbing, because according to the Ethics code of heath care professionals, the nursing profession is based on except humanity and compassion, but also on professional competence.
The data show that nurses have a deficiency in knowledge about management of pain.
We have given an opportunity to the patients to select what kind of care they are receiving from a nurse most frequently.
Fig. 5 - Different kind of care from nursing point of view
The results provided a convincing evidence that all patients received the necessary medical care, but there has been a deficit in relation to the other types of care, and the least covered are physical and social support. Nurses’ opinion differs substantially from patients’ in the terms of psychological Р<0,001 [u=8, 77], physical Р<0,001 [u=5, 83] and social support Р<0, 05 [u=2, 56] (Fig. 5).
The quality of nursing care in the hospital must meet the expectations of the patient and his needs. This quality is influenced by a number of factors. On the first place is the qualification of the health specialists.
Disturbing is the opinion of the respondents about the neglect of important medical activities. The activities of the modern nurse are not limited to the performance of medical manipulations, but include: maintaining the highest possible level of physical and mental comfort, needs assessment of the patient based on professionalism and knowledge.
The bulk of the patients [81, 8%] in this study believed that the quality of nursing care depends on the qualification of the medical staff. Only six respondents gave a negative answer. Roughly one-seventh of the respondents answered with “I can’t decide” (Fig. 6).
Fig. 6 - Quality of medical care and qualification according to the patients
Based on the data obtained from the survey, recommendations were made to improve the health care for adult patients and for adapting the education training of the health professionals to the requirements for carrying out competent geriatric care in Bulgaria.
The understanding and providing of appropriate care and support for older people would not be substantially changed without a change in the management and organization of work in health care facilities, in qualification increase of the health specialists in training, as well as in many attitudes and negative stereotypes of many medical specialists to aging and geriatric patients.
The health care for older patients has its own characteristics that are related to the aging process. They give that specificity into the clinical course of the diseases, of the therapeutic impact and of the treatment results from the people of older age groups.
To provide effective care to this contingent of sick people some specific competencies of the nurses are needed about the peculiarities of the clinical manifestations of individual group of diseases, and knowledge about the bio-psychosocial factors, affecting the health and illness of the geriatric patients.
In this case the provision of modern educational gerontological training of health professionals, which are providing geriatric care adapted to their specific professional needs, is one of the preconditions for reaching of the needed competence when it comes to implementation of health care for older patients in inpatient settings.
References
- Krasteva, N. “Theoretical foundations of the nursing care” – Plovdiv, 2005, pages 9-10
- Balanska, P., S. Mladenova, N. Georgiev. Aging of the population and guidelines in the development of health care. Nursing, 40, 2008, 4, 30-33.
- Balanska, P. Problems and trends in the training of professionals, providing care for older people, Bourgas, accad. Magazine Management and education. ISSN: 13126121, 2008, t. 4, 3; 76 – 80.
- Sindzimova, D., M. Sindzimov. Sources of relevant information for the GPs in Bulgaria. Management and education. Book 1, vol. 5, 2009, pages 140-142
- P., Gaps in the provision of quality hospital services, 2010, Jubilee scientific conference with international participation “Health in the 21st century”, Reports, vol. 1, Publishing center of MU – Pleven, ISBN 978-954-756-098-7, pages 344-347.
- Ordinance № 1 from 08.02.2011 on professional activities that nurses, midwives, associated medical specialists and healthcare assistants may perform by assignment or by themselves. Created by the Minister of Health, SM, № 15 from 18.02.2011, № 40 from 01.07.2011.
- Popov, M., B. Davidov and M. Marinov. Humanized hospital – from conception to realization. Sofia, Foundation, Open society, 2000, page 13