Introduction: Healthcare reengineering is a powerful methodology of change that helps organizations rearrange priorities, provide cost-effective treatment, and increase the quality of patient care.Aim: To determine the attitudes and opinions of healthcare professionals according to the needs for reorganization processes, evaluation of the profession and responsibilities for performing more complex jobs and tasks. Material and methods: The study is theoretical and empirical. An exploratory method and a descriptive analytical method for research using a questionnaire instrument were used to collect secondary data. The study was conducted among 108 healthcare professionals who completed one of the studies at the Faculties of Health Studies in Bosnia and Herzegovina and who are employed in the Public Healthcare Centers of Sarajevo Canton and among 6 managers of regional Healthcare Centers in Sarajevo Canton. Two original author questionnaires created on the basis of practical experience were used as a study instrument. The study was conducted in the period from September 1st to November 30th, 2019.Results: Out of the total number, 87% of respondents believe that they are fully ready to take on new, more demanding tasks within their work, and 67% of them believe that they have enough education to perform more responsible jobs. In most cases, the heads of institutions expressed a positive attitude towards taking on greater obligations and responsibilities in the work process. Only 50% of the heads of institutions state that they have a strategic plan for reorganization and optimization of staff with a degree in healthcare.Conclusion: Healthcare professionals who have completed their studies at Faculties of Health Studies can competently perform more complex and responsible jobs and tasks in health centers with additional training, which is confirmed by their managers. It is necessary to adopt a Strategic Plan for the development, reorganization and optimization of health personnel at the level of primary healthcare, which would significantly improve the quality of work.
Aim To evaluate modalities of extensor tendons repair of hand and forearm in specific anatomical zones with regard to etiological factors and presence of associated injuries of adjacent anatomical structures. Methods This cross-sectional study included 279 patients referred for extensor tendon repair of hand and forearm in specific anatomical zones. Available treatment modalities were evaluated concerning etiological factors, anatomical zones, and associated injuries. Statistical significance was analysed in the occurrence of early and late postoperative complications according to anatomical zones. Results Direct repair of extensor tendon lesions was found to be the most common modality of reconstruction, 230 (93.5%), of which blade injuries were predominant, 120 (48.7%). Direct tendon repair was mostly indicated in Zone VI and Zone III, in 55 (23.9%) and 42 (18.3%) patients, respectively. Statistically, a significant correlation was confirmed between treatment modalities, injuries in specific anatomical zones, and type of etiological factor (p<0.0001). Statistical correlation was confirmed between zones of injuries and the occurrence of early and late complications (p=0.002). Conclusion Successful postoperative recovery was correlated with the recognition of functional failure in specific zones, assessment of potential associated injuries, and selection of the most optimal modality of reconstruction.
Introduction: Rhinoplasty is an esthetic and functional nasal reconstruction surgery. The elimination of physical disabilities directly affects mental health and leads to a better psychological balance. Therefore, patient satisfaction is considered a valuable measure of medical service outcomes. The objectives of this study were to evaluate subjective patient satisfaction 1 year after surgery and its influence on the quality of life.Methods: This was a clinical, retrospective, randomized, and single-blinded study in which patients were randomly questioned by the same examiner. All subjects underwent pre-operative preparation and post-operative flow at Eurofarm Centre from 2007 to 2010. The survey was conducted through anonymous questionnaires that were provided to each respondent at least 1 year after discharge from the hospital.Results: Overall, 20 (50%) patients had esthetic and 20 (50%) had functional nasal surgery. Most respondents were born between 1971 and 1980 (52.5%) and between 1981 and 1991 (40%), with the least born between 1951 and 1960 (2.5%). Regarding the education level, 27 had university degrees (67.5%), 1 had postgraduate education (2.5%), and 12 (30.0%) were secondary school graduates. In addition, 25 (62.5%) were unmarried and 15 (37.5%) were married.Conclusion: No statistically significant correlation was found between the subjective assessment of patient’s health based on eight dimensions of health assessment and variables such as type of surgery, age, level of education, and marital status 1 year after undergoing rhinoplasty. A statistically significant difference was found between the type of surgery and physical pain (p = 0.004 < 0.05, Mann–Whitney U test). Based on the research findings, we can conclude that patient satisfaction after undergoing rhinoplasty was moderately correlated positively with the quality of life (r = 0.180-0.345, p < 0.05).
Continuous progress in the nursing profession has a significant impact on the quality in the process of clinical care, which brings about new challenges and tasks for nurses to invest in new knowledge and skills. The healthcare process requires a systematic team approach in the design of evidence-based tasks, good clinical practice and clinical guidelines, documented standardized phenomena and evaluated measurements and tests. Measurement instruments and statistical tests of treatment effectiveness are used to assess the quality of health care provided. For a successful measurement and analysis of the quality of clinical care, it is necessary to have standardized healthcare documentation that allows treatment and outcomes monitoring. Qualitative and safety indicators are used to assess the quality of clinical health care, which represent a means of measurement, screening or warning. Monitoring Quality and Safety Indicators in Health Care Services is used as a guide to monitoring, evaluating and improving the quality of health care, and supporting services and organizational functions. In the field of health care, we measure the total treatment, outcome of the healthcare process, patient satisfaction, unwanted events,quality of life, etc.
Continuous progress in the nursing profession has a significant impact on the quality in the process of clinical care, which brings about new challenges and tasks for nurses to invest in new knowledge and skills. The healthcare process requires a systematic team approach in the design of evidence-based tasks, good clinical practice and clinical guidelines, documented standardized phenomena and evaluated measurements and tests. Measurement instruments and statistical tests of treatment effectiveness are used to assess the quality of health care provided. For a successful measurement and analysis of the quality of clinical care, it is necessary to have standardized healthcare documentation that allows treatment and outcomes monitoring. Qualitative and safety indicators are used to assess the quality of clinical health care, which represent a means of measurement, screening or warning. Monitoring Quality and Safety Indicators in Health Care Services is used as a guide to monitoring, evaluating and improving the quality of health care, and supporting services and organizational functions. In the field of health care, we measure the total treatment, outcome of the healthcare process, patient satisfaction, unwanted events, quality of life, etc.
Objective: To investigate possible prognostic values of CD4+, CD8+ T-lymphocytes, CD4/CD8 ratio to clinical course of chickenpox in immunocompetent hosts. Materials and methods: We performed a prospective study which included 69 immunocompetent patients with chickenpox who were addmited to Clinic for infectious disease, Clinical Center University of Sarajevo, in a 18 month period. All patients were divided into two groups depending on clinical presentation on admission. Patients with mild clinical form were dedicated to „outpatient” group, and patients with moderate, severe or life-threatening clinical forms were dedicated to „hospitalized” group. Also 30 healthy volunteers are included in study as a control group. We analyzed values of CD4+, CD8+ percentage, CD4/CD8 ratio with comparison to clinical course of chickenpox. All specimens were taken in acute phase of illness. Results: Values of CD4+ percentage were significantly declined in a group of hospitalized patients, compared to group of outpatients and control group. Values of CD8+ percentage were higher in a group of hospitalized patients, while CD4/CD8 values were lower in comparison to a group of outpatients and control group. Conclusion: We found significant correlation between these parameters and clinical course of chickenpox.
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