Assessment of hypertension chronic care model: Pacic application in Bosnia and Herzegovina.

The objectives of this study were to evaluate patients' attitudes towards hypertension treatment according to the chronic care model and to assess the implementation of hypertension clinical guidelines in family medicine. The cross-sectional study was carried out in two randomly selected primary health care centers (Bijeljina and Prijedor), respectively in Bosnia and Herzegovina, covering the period between March and April 2016. This study sample consists of 791 respondents with hypertension purposing to measure specific actions and quality of care for hypertensive patients. The Patient Assessment of Chronic Illness Care (PACIC) was used. Treatment for the indicators of hypertension was assessed by analyzing patients' medical charts according to the recommendations of clinical guidelines. More than half of the evaluated indicators of treatment for hypertension were documented in medical charts of 84.07% patients. The average overall PACIC score was 4.18 (SD 0.59), being an average of the separate scores of 4.19 (SD 0.57) in men and 4.17 (SD 0.60) in women. Subscale means of PACIC were as follows: patient activation 4.33, delivery system design 4.36; goal setting 4.03; problem solving 4.51; follow-up and co-ordination 3.67. No statistically significant correlations in the overall score and subscale scores were found by demographic characteristics. Non-smokers had a significantly higher overall score compared to smokers (p = 0.001). As implementation of the guidelines became stronger, the reported PACIC scores rose. Continuing the education of patients in order to achieve better health care outcomes is imperative.

Occupational exposure to blood and body fluids among health-care workers in Serbia.

OBJECTIVES: The aim of this study was to examine the epidemiology of occupational accidents and self-reported attitude of health-care workers (HCWs) in Serbia. SUBJECTS AND METHODS: A cross-sectional study was conducted among HCWs in selected departments of five tertiary care hospitals and in one secondary care hospital in February 2012. A previously developed self-administered questionnaire was provided to HCWs who had direct daily contact with patients. χ(2) test and Student's t test were used for statistical analysis of the data. RESULTS: Of the 1,441 potential participants, 983 (68.2%) completed the questionnaire: 655 (66.7%) were nurses/medical technicians, 243 (24.7%) were physicians and 85 (8.6%) were other personnel. Of the 983 participants, 291 (29.6%) HCWs had had at least one accident during the previous year and 106 (40.2%) of them reported it to the responsible person. The highest prevalence (68.6%) of accidents was among nurses/technicians (p = 0.001). Accidents occurred more often in large clinical centers (81.1%; p < 0.001) and in the clinical ward, intensive care unit and operating theater (p = 0.003) than in other departments. Seventy-six (13.1%) nurses/medical technicians had an accident during needle recapping (p < 0.001). Of all the HCWs, 550 (55.9%) were fully vaccinated, including significantly more doctors (154, 63.4%) than participants from other job categories (p < 0.001). CONCLUSION: There was a relatively high rate of accidents among HCWs in our hospitals, most commonly amongst nurses and staff working in clinical wards, intensive care units and operating theaters. The most common types of accidents were needlestick injuries and accidents due to improper handling of contaminated sharp devices or occuring while cleaning instruments or by coming into contact with blood through damaged skin or through the conjunctiva/mucous membranes.

Knowledge and occupational exposure to blood and body fluids among health care workers and medical students.

INTRODUCTION: Health workers and medical students are at occupational risk of blood-borne diseases during the accidents, that is, via percutaneous injury or entry of blood or body fluids through the mucosa or injured skin. OBJECTIVE: to review and analyze the knowledge, attitudes and perception of risks of bloodborne diseases of the clinical course students and health workers as well as the frequency of accidents. MATERIAL AND METHODS: Cross-sectional study was carried out among the students of the Faculty of Medicine in Belgrade, and health workers of the Clinical Center of Serbia. The subjects responded anonymously to questionnaire specially designed for the study. RESULTS: Both students and health workers were aware, in a high percentage, of the fact that the risk of hepatitis B spread was about 30%. Significantly more students gave affirmative reply that blood as biological material was a potential hazard of HIV infection spread (p = 0.001), and significantly more students knew that HIV would not be spread by sweat (p = 0.001). Hepatitis B vacci-nation was administered only to 24.1% of students and 71.4% of health workers. About 10% of students and 65.5% of health workers experienced some accident. There was no significant difference of accidents bet-ween nurses/technicians and physicians (p > 0.05), as well as of accidents and a total length of service (p > 0.05). The majority of accidents occurred during the use of needle/sharp object (in 27.3% of students and 33.1% of health workers). About 40% of students and slightly over a half of the workers reported the accidents to appropriate authorities. Additional education in this field is considered necessary by 73% of students. CONCLUSION: During the studies and via continuous medical education it is necessary to upgrade the level of knowledge on prevention of accidents, what would, at least partially, influence their reduction.