Acute Abdominal Pain Assessment in the Emergency Department: The Experience of a Greek University Hospital.

BACKGROUND: Acute abdominal pain (AAP) is a common symptom in the emergency department (ED). Because abdominal pain can be caused by a wide spectrum of underlying pathology, evaluation of abdominal pain in the ED requires a comprehensive approach, based on patient history, physical examination, laboratory tests and imaging studies. The aim of this study was to investigate predictive factors for admission to the hospital in patients who presented to the ED with AAP as the main symptom. METHODS: This prospective observational study enrolled 125 patients who presented with AAP in the ED of the Patras University Hospital in western Greece. The sample of patients who enrolled in the study was representative of patients who receive care in this academic institution. All patients underwent clinical examination, laboratory testing and radiological assessment. Clinical and laboratory data were analyzed in an attempt to identify clinical or laboratory factors predicting hospital admission. RESULTS: Based on clinical, laboratory and radiologic evaluation, 37.6% of patients enrolled in the study were admitted to the hospital, whereas 62.4% were not admitted. Compared to patients who were not admitted, patients admitted to the hospital had higher age and significantly higher inflammatory markers, white blood count and C-reactive protein (CRP). Binary logistic regression analysis showed that abnormal imaging findings (odds ratio (OR) = 6.47, 95% confidence interval (CI): 2.11 - 19.77, P < 0.001) and elevated serum CRP levels (OR = 6.24, 95% CI: 2.16 - 18.03, P < 0.001) were significant predictive factors for hospital admission. CONCLUSIONS: Assessment of AAP remains a challenging problem in the ED. Comprehensive history combined with detailed clinical examination, appropriate laboratory testing and radiologic imaging facilitates effective assessment of patients who present in the ED with AAP and guides the decision to admit patients to the hospital for further care.

Workplace violence against nurses in three different Greek healthcare settings.

BACKGROUND: Healthcare workers are at high risk of facing workplace violence and nurses represent the most affected group. OBJECTIVE: This study aimed to assess workplace violence encountered by nurses working in three different healthcare settings. METHODS: This was a cross-sectional study conducted in a tertiary hospital, a non-tertiary hospital and a primary care unit. The research tool was an anonymous self-report questionnaire concerning the prevalence, characteristics, consequences, causes and preventive measures of workplace violence. The statistical analysis was performed with SPSS 17.0. RESULTS: Eighty nurses participated in the study. The majority (76%) had experienced workplace violence. Men (OR, 0.08; 95% CI, 0.01-0.56) and more experienced nurses (OR, 0.82; 95% CI, 0.70-0.97, for each additional year of working experience) were less affected in the last year. Verbal violence was the dominant type (98%). The vast majority (80%) reported a negative psychological impact, while 65% reported that they feel sometimes, rarely or never safe in their workplace. One of the main suggested causes of workplace violence was the long waiting time (99%), while the most common suggested measure of prevention was entrance control (93%). CONCLUSIONS: This study revealed a high prevalence of workplace violence against nurses working in different healthcare facilities. Country and unit-specific studies may be beneficial for implementing appropriate interventions for reducing work place violence.

Assessment and Analysis of Workplace Violence in a Greek Tertiary Hospital.

This study sought to assess workplace violence in a Greek tertiary hospital for the first time. The authors conducted a descriptive study with 175 participants and examined the characteristics of violent episodes, the responses of victims and the administration, and the perception of workplace safety in addition to the implications of these incidents. The vast majority of employees (83.4%) had experienced work-related violence; however, half of them (52%) had not reported the incident to the hospital administration. Verbal violence was the most common type of incident (98.6%). Nurses and other health care staff reported feeling safer than physicians (odds ratio [OR] = 4.47, 95% confidence interval [CI]: 1.94-10.28 and OR = 2.80, 95% CI: 1.64-8.74, respectively). A large proportion of victims (72.6%) suffered psychological consequences following the violent incident. This study reveals the high prevalence of workplace violence in a Greek tertiary hospital and underscores its negative impact on health care workers.

Bacterial contamination of medical devices in a Greek emergency department: impact of physicians' cleaning habits.

We investigated the bacterial contamination of physicians' stethoscopes, electrocardiography machines, cardiac monitors, and pulse oximeters, as well as physicians' self-reported cleaning habits in the emergency department of a university hospital. Among 100 devices evaluated (stethoscopes included), 99% developed a positive bacterial culture. Coagulase-negative staphylococci predominated (80.3%). Only 13% of physicians reported cleaning their stethoscope after each patient examination; multinomial regression analysis found less contamination on those stethoscopes (P < .001). Studies on the implementation of hygiene measures are needed.