The Burden on Carers with Multiple Sclerosis.

BACKGROUND: The family members of patients with multiple sclerosis (MS) are called to become carers, playing a vital and difficult role in supporting the patients in their daily life. The aim of this study was to investigate the extent of the multidimensional burden on the carers of multiple sclerosis. METHODS: Data were collected from 111 carers with MS patients. The survey was conducted in Patras General Hospital. RESULTS: According to the research findings, the multidimensional burden of carers is proportional to the severity of the patient's condition. In particular, the majority of patients were in a good kinetic state, so the carers examined felt gentle with a moderate burden. On both scales, Zarit and BAKAS, it was observed that the age of the caregiver, the type of care he provides, and the patient's dependence on him increase the feeling of the burden. Positive results from care improve the caregiver's relationship with the patient, his self-esteem, and his ability to cope with stress. According to the F-COPES scale, it is observed that the relationship between the caregiver and the patient is responsible for accepting the problem; the greater the caregiver's age, the higher the percentage of those seeking help from doctors, social services. CONCLUSIONS: The burden on carers is indisputable; support from family members, social and economic support, and education may mitigate the burden of care.

Medication Errors and Their Correlation with Nurse's Satisfaction. The Case of the Hospitals of Lasithi, Crete.

BACKGROUND: Medication errors have been recognized as a real problem for all health systems worldwide and are the most common category of nursing errors. The aim of this study was to investigate the prevalence of medication errors and their correlation with the job satisfaction of nurses. METHOD: A prospective cross-sectional study was carried out and the sample of the study consisted of 189 nurses. To investigate medication errors, an anonymous structured questionnaire of 34 questions was used and Job Satisfaction Survey (JSS) questionnaire was used to measure job satisfaction. The IBM SPSS 25.0 program was used for statistical analysis of the data. RESULTS: 63.0% of nurses have been errors in the administration of medication, more often by the wrong time of administration (34.4%), missed dose (22.8%), and wrong dose (21.7%). The likelihood of an error is similar in all shifts, its devaluation is a non-reference reason, and if reported to a greater frequency in the attending physician. A significant difference in the frequency of errors was found only in the marital status and the job, while under the working conditions no significant variation was recorded. Job satisfaction is statistically significantly low for financial earnings and high for the management supervision. Based on the findings, the correlation between total job satisfaction and medication errors was not significant. CONCLUSIONS: Nursing medication errors continue to happen. Continuing education, formal recording, and improvement of working conditions could help prevent and minimize errors and at the same time increase the job satisfaction of nurses.

Investigating Nursing Leadership in Intensive Care Units of Hospitals of Northern Greece and Its Relationship to the Working Environment.

INTRODUCTION: The relationship between leadership and the work environment has been studied by many authors at the organization level, but not specifically in intensive care units (ICUs). The aim of this study was to investigate the possible relationship between the work environment and nursing leadership in intensive care units. METHODOLOGY: This is a correlation study. The study population consisted of nurses and nursing assistants with at least 6 months of experience in ICUs of Northern Greece hospitals. Data were collected using the Greek version of the Practice Environment Scale of the Nursing Work Index (PES-NWI) and the Multifactor Leadership Questionnaire (MLQ). Statistical analysis of data was done with IBM SPSS v. 22.0. RESULTS: A total of 64 nurses aged 43.6 ± 6.4 years were included. In the work environment, the dimensions of nursing staff competence (2.4 ± 0.6) and relationships between nursing staff and physicians (2.4 ± 0.6) were higher, and the dimensions of nursing staff involvement in decision-making in hospital (2.3 ± 0.6), nursing authorities on the quality of healthcare (2.2 ± 0.6), and supervisor abilities and support to nursing staff (2.2 ± 0.6) had the lowest score. The highest scores on the leadership questionnaire were personalized interest (2.6 ± 0.8), and exceptional management (passive) (2.6 ± 0.9). CONCLUSIONS: The work environment was not related to nursing leadership. Nurses need individual development plans that include the type of knowledge, skills, attitudes, and values required for leadership. In this context, continuing training centers play an important role because they are responsible for training and developing leaders who are fit for work in intensive care.

Central-Line-Associated Bloodstream Infections (CLABSIs) Incidence and the Role of Obesity: A Prospective, Observational Study in Greece.

INTRODUCTION: Although central venous catheters (CVCs) provide reliable vascular access, there are several risks linked with their use, with the rates of central-line-associated bloodstream infections (CLABSIs) being the most important ones. CLABSIs have a big impact on mortality rates and health care costs. The aim of this study was to investigate the incidence of obesity in the development of central venous catheter infections. MATERIAL AND METHOD: This is a prospective, observational study. The data were collected in the ICUs of three major hospitals in Greece, over a period of 18 months. Totally, 744 patients were included in the study. RESULTS: The study included 744 ICU patients aged 63.6 ± 16.6 years. The Apache II score and MODS score of patients were 23.3 ± 6.9 and 7.5 ± 3.8, respectively. Totally, 5.426 catheter-days were included in the study. Among the 722 CVCs, 178 (24.7%) were CLABSIs. The incidence rate of CVC-associated CLABSI was 22.48 infections per 1000 catheter-days. CLABSI was significantly predicted by the BMI (p = 0.001), by the diabetes mellitus as comorbidity (p = 0.013), by the doctors' experience (p = 0.001), by the type of CVC (p = 0.001) and CVC site (p = 0.001), by the number of efforts for CVC insertion (p = 0.009), by the catheterization's duration (p = 0.001) and by the MODS score (p = 0.001). CONCLUSIONS: Better staff training focused on care bundles preventing infections, better medical training focused on less efforts for CVC insertion, and the use of Ultrasounds during the CVC insertion may be the main factors that can lead to lower CLABSI rates in obese patients. Further research relating CLABSI rates in ICU patients and obesity is needed.

Burden and Sleeping Disorders of Family Caregivers of Hemodialysis Patients with Chronic Kidney Disease-End Stage: A Cross-Sectional Study.

BACKGROUND: Chronic illnesses with high level of disability can affect not only the patients but also the main caregiver who supports them. The aim of this study was to investigate the burden and sleep disorders of family caregivers of hemodialysis patients. METHODS: This is a cross-sectional study. The sample of the study consisted of 310 family caregivers of hemodialysis patients. The tools used were the Pittsburgh Sleep Quality Index (PSQI) for sleep disorders assessment, the Zarit Burden Interview, and the Center for Epidemiologic Studies-Depression Scale (CES-D) for burden and depression assessment, respectively. RESULTS: The total burden of caregivers was serious at 35.5%, and this rate increased to 64.8% if we added the moderate burden. About 26.7% of caregivers were positive in depressive symptoms and 20% at risk (predisposition) for depression. The factor with the greatest correlation with the overall burden was personal strain (r = 0.952, p < 0.001) followed by the role strain factor (r = 0.901, p < 0.001). About half of the respondents (51.6%) had poor quality of sleep. The factors that were strongly related to the overall degree of sleep quality were the actual sleep duration and daytime dysfunctions. CONCLUSIONS: Caregivers of hemodialysis patients face an increased risk for burden and sleep disorders development. Continuous and regular assessment of the caregivers' quality of life and the provision of psychological support may reduce the burden of caregivers and improve the emotional disorders they face.

Sleeping Disorders and Health-Related Quality of Life in Hemodialysis Patients with Chronic Renal Disease in Greece.

INTRODUCTION: Increased life expectancy in patients with end-stage renal failure undergoing dialysis and the high prevalence of the chronic renal disease highlight the need to investigate the patients' quality of life. AIM: To investigate sleep disorders and the level of health-related quality of life in hemodialysis patients with chronic renal failure. MATERIAL AND METHOD: The sample of the study consisted of 420 hemodialysis patients. The Kidney Disease and Quality of Life™ Short Form questionnaire was used to assess the quality of life of patients, and the Pittsburgh Sleep Quality Index was used to investigate sleep disorders. RESULTS: The physical and mental health of the responders were found to be 36.9 and 39.6, respectively, while the burden and effects of chronic renal disease were found to be 40 and 44.9, respectively. There were strong positive correlations between the overall health assessment and the emotional well-being (r = 0.743), the physical function (r = 0.730), the burden of renal disease (0.626), the energy/fatigue (0.643), the social function (0.639), and the pain (0.595). The patients' quality of sleep was found poor (7.62). The major correlation was observed between the total score and the dimension of the sleep latency (0.681), followed by the sleep disturbances (0.624). CONCLUSIONS: The HRQOL of hemodialysis patients with CKD-FS remains poor, interacting with important functions such as sleep, vitality, cognition, and sexual function.

Compliance of Patients with Acute Coronary Syndrome with Treatment Following Their Hospitalization from the Cardiac Coronary Unit.

BACKGROUND: Low compliance rates with medication after an acute coronary syndrome (ACS) is a serious public health problem with adverse socioeconomic implications for both patients and their families as well as for health systems in general. The aims of the study are to measure the levels of compliance with medication in the treatment of patients who suffered from ACS and to investigate the factors contributing to the noncompliance. METHODS: The sample consisted of 100 patients hospitalized in the coronary care unit (CCU) of a general hospital. The compliance of patients with treatment, which was measured with the GR-SMAQ and ARMS scales, was measured at 3, 6, and 12 months after their hospitalization. The t-test and control X2 were used, and the value of statistical significance was set to 0.05. RESULTS: According to the GR-SMAQ and ARMS scales, compliance of patients at 3, 6, and 12 months after hospitalization is low (58%, 70%, 32% with ARMS scale and 54%, 58%, 38% with GR-SMAQ scale, respectively). Patients who were readmitted to CCU had 68.9% less chances of showing compliance, and patients who had normal levels of systolic blood pressure were 3.5 times more likely to adhere to their treatment. No correlation between compliance and social demographic data, such as gender, age, level of study, and family and occupational status, was found (p > 0.05). CONCLUSION: Compliance of patients who suffered from ACS is at low level. There is a need for closed monitoring and use of wearable devices in order to improve the compliance rates.

Perioperative inadvertent hypothermia among urology patients who underwent transurethral resection with either TURis or transurethral resection of the prostate method.

PURPOSE: The purpose of the study was to investigate the incidence of perioperative hypothermia in urology patients undergoing transurethral resection with either TURis or transurethral resection of the prostate method and to recognize the risk factors that were responsible for the occurrence of hypothermia intraoperatively in these patients. METHODS: It was a randomized prospective study. A total of 168 patients, according to American Society of Anesthesiologists physical status I-III, were scheduled for transurethral resection either with TURis or transurethral resection of the prostate method. We measured the core body temperature before (preoperative), during (perioperative) and after (postoperative) the surgery. Age, body mass index, American Society of Anesthesiologists score, duration of surgery, preoperative prostatic volume, and vital signs were also recorded. RESULTS: The prevalence of inadvertent hypothermia was 64.1% for the TURis group and 60% for the transurethral resection of the prostate group. Hypothermic patients in TURis group were significantly older (87.7 ± 1.7 vs 68 ± 6.7 years, p < 0.05) and had lower body mass index (26.9 ± 3.6 vs 29.2 ± 2.7, p < 0.05), while hypothermic patients in the transurethral resection of the prostate group were significantly older (86 ± 1.1 vs 70 ± 7.4 years, p < 0.05) and had notably higher duration of surgery (140.6 ± 28.9 vs 120.3 ± 14.3 min, p < 0.05) than normothermic patients. CONCLUSION: Perioperative inadvertent hypothermia among urology patients who underwent transurethral resection with both TURis and transurethral resection of the prostate method is of high incidence. We recommend monitoring of the temperature of core body of all these patients, especially those with advanced age and lower body mass index.

Body mass index and outcome of out-of-hospital cardiac arrest patients not treated by targeted temperature management.

BACKGROUND: Obesity has been demonstrated to increase the risk of out-of-hospital cardiac arrest (OHCA) and may influence the quality and effectiveness of cardiopulmonary resuscitation. Our aim was to investigate the association between body mass index (BMI) and the outcome of OHCA victims not treated by targeted temperature management. METHODS: This was a prospective observational study of OHCA patients. The patients were categorized according to BMI into two groups: the normal BMI group (nBMI) and the elevated BMI group (eBMI). The primary endpoint was return of spontaneous circulation (ROSC), while secondary outcomes were survival to intensive care unit (ICU) admission and survival to ICU discharge. RESULTS: Of the initial 99 patients who were transported to the Emergency Department, 84 (85%) were included in the study. Mean BMI was 29.8kg/m2. Thirteen (15.5%) patients achieved ROSC and were admitted to the ICU, with the mean duration of ICU length of stay being 6.7±4.9days. Survival to ICU admission and ICU discharge were higher in the eBMI group (17.6% vs. 6.25%, p=0.010 and 10.3% vs. 6.25%, p=0.021, respectively). Survival to ICU discharge was higher in ventricular fibrillation patients compared to patients with non-shockable rhythms, irrespectively of their BMI (p=0.002). All patients that survived to ICU discharge did so with a cerebral performance category score of 2. CONCLUSIONS: Survival to ICU admission and ICU discharge were higher in the eBMI group.

Clinical Use of Smartphones Among Medical and Nursing Staff in Greece: A Survey.

The aim of this study was to investigate the clinical use of smartphones among medical and nursing staff in Greece. This study used a 17-item questionnaire that was administered to the participants by the authors. The sample consists of 974 participants of 1200 who were asked to participate (ie, a response rate of 81.3%). The survey was open to all categories of medical and nursing staff (junior doctors, specialized doctors, assistant nurses, and RNs). In total, 167 participants (18.5%) were nurse assistants; 385 participants (42.6%), nurses; 154 participants (17%), specialized doctors; and 198 participants (21.9%), junior doctors. The data analysis was performed using SPSS Statistics (version 21), and the significance level was set to .05. Medical doctors own smartphones on a higher percentage in comparison with nurses. Among smartphone owners, medical doctors use their devices for clinical issues more frequently compared with nurses. Although medical doctors believe that smartphones can be a great tool for their work, they state that they do not use it for clinical reasons. Nurses state that they do not use their smartphones for clinical reasons because they are not aware of the existence of applications that can be used to assist them in their daily clinical tasks.

Information-Seeking Behavior of Greek Nursing Students: A Questionnaire Study.

The aim of this study was to investigate factors influencing the use of electronic journals by nursing students through identification of information needs, information resources used, and barriers to seeking information. A cross-sectional study was conducted using a specially designed structured questionnaire. Of 600 nursing students, 505 agreed to participate, indicating a response rate of 84.2%. Participants sought out nurses and doctors, printed materials, scholarly databases/e-journals, and seminars as information resources. Participants reported that they searched for information for themselves, parents, and inpatients. Most searched for information for diet or special nutrition needs and for specific diseases. The obstacles faced included lack of time and cost. Training in information literacy is important to enhance the skills of nursing students.

The importance of vital signs in the triage of injured patients.

BACKGROUND: Vital signs are indicators of a patient presenting to an emergency department (ED). Abnormal vital signs have been associated with an increased likelihood of admission to the hospital. Physicians have long recognized the importance of vital sign observations, and vital sign measurement has proven to be useful for detecting serious diseases during triage in EDs. METHODS: The study included all patients with injuries presented to the ED of a general hospital in Greece. For these patients, sex, age, cause of injury, vital signs at the time of admission to ED (systolic blood pressure, diastolic blood pressure, mean blood pressure, heart rate, and oxygen saturation), and the course of the patient (admission to hospital, discharge from ED) were recorded. The statistical analysis of data was done by the statistical package SPSS 15. It was performed using univariate regression and Spearman correlation coefficient. RESULTS: A total of 2703 patients were registered, of which 71% were men aged 31.9 ± 0.38 years and 29% were women aged 45.7 ± 0.79 years. The main causes of injury were car accident, motor accident, pedestrian accident, fall from a height, and assault. By logistic regression, the correlation was found between mean blood pressure, systolic blood pressure, oxygen saturation, and hospitalization or discharge of the patients. CONCLUSIONS: The measurement of mean blood pressure, systolic blood pressure, and oxygen saturation of the injured patients during the admission to the ED can predict the disease course of patients.

The impact of ED boarding time, severity of illness, and discharge destination on outcomes of critically ill ED patients.

This aim of this study was to determine the association between emergency department (ED) boarding time, severity of illness, and outcomes for critically ill patients. This was a prospective cohort study of ED patients who met criteria for admission to the intensive care unit (ICU). Patients were divided into 2 groups: those who spent less than 6 hr in the ED prior to transfer, and those who spent 6 hr or more. The groups were compared on the basis of severity of illness, Glasgow Coma Scale score, presence of fever, admission time, and hospital survival. Factors associated with increased mortality included patients who spent 6 hr or longer in the ED, had a fever, were admitted in the evening or night, or were indirect ICU admissions. Length of time spent in the ED prior to transfer to inpatient care is one of several factors associated with increased mortality in critical care patients who were intubated in the ED.