EAEIBE
Εταιρεία Αναισθησιολογίας και Εντατικής Ιατρικής Βορείου Ελλάδας (ΕΑΕΙΒΕ)
HSA
Ελληνική Αναισθησιολογική Εταιρεία

2016a

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Contemporary changes in medical science and scientific publishing practices are hard to understand and even harder to follow. In the past it was enough to talk about “medicine” and “announces”/papers written by an author-researcher-doctor. Today one can easily claim that there are constellations of medical fields and publishing practices and still, not describe the reality.

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At 2012 the ICU of General Hospital of Trikala has registered as CAF user in the CAF database. With this quality management instrument, public sector organizations improve their performance by recognizing weaknesses and by promoting strong points. The purpose of using CAF protocols is to improve the quality of provided Health services. For the implementation of CAF we used specialized questionnaires such as: CAF questionnaire, family satisfaction (FS- ICU 24), questionnaire concerning nursing care (TISS - 28) and about fatique of personnel (Burn-out questionnaire). Also, indicators such as observations of mortality in relationship with the cost (SMR/SRU), Bacteraemias, V.A.P (Ventillation associated pneumonia), and the effectiveness of nurse project (Level of ICU) have been used. The design of CAF protocol implementation was adjusted, as structure, according to the data of our ICU. General Indicators concerning Public sector administration have been used but also specialized indicators concerning ICU output, mortality rate, infections and cost. Undergoing this project by using the CAF quality instrument the target is to identify fields were effective functioning was observed (strong points) and fields that need improvement (weak points). The purpose is, throughout self assesment evaluation but also with Bench-marking with other ICUs, to improve the provided health services from the ICU of General Hospital of Trikala.

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Postoperative pain management has become pre-requisite for early recovery after laparoscopic chole-cystectomy and the ideal management of it is definitely multimodal due to the complexity of its na-ture. Many analgesic approaches have already been tested to relieve pain after laparoscopic cholecys-tectomy and anticonvulsants drugs, like pregabalin and gabapentin might be useful and effec-tive.Pregabalin is an antiepileptic drug that is often used to treat neuropathic pain. The use of pre-gabalin as part of multimodal analgesia is still under evaluation and may have a role in the postopera-tive management, as an adjunct. Several studies have evaluated the efficacy and adverse effects of pregabalin in reducing postoperative pain and opioid consumption.In this review, we discuss the role of pregabalin in acute postoperative management after laparoscopic cholecystectomy. Based on avail-able clinical trials it is difficult to draw solid conclusions. More studies and especially well designed clinical trials are required in order to clarify the optimal dose and the duration of therapy before adopt-ing pregabalin in routine clinical practice.

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This research was designed to determine the appropriateness and applicability of the Patient Bill of Rights from the viewpoint of nurses in Lorestan University of Medical Sciences to identify barriers and provide operational solutions in 2012. This is a descriptive-analytical study. Out of 440 questionnaires delivered to the nurses, 294 were completed. The data collection tool was a questionnaire related to the five domains of the Patient Bill of Rights including right to receive appropriate services, right to receive appropriate and adequate information, right to choose and decide on health services freely, respecting patient privacy and observing the principle of confidentiality, and finally right to get access to effective complaint handling system. The mean scores for appropriateness (350.16±7.23) and applicability (282.57±54.22) of the Patient Bill of Rights were high. Shortage of work force, nurses and patients’ unawareness of the major barriers of application, provision of necessities for internalization, establishment of the committee of the Patient Bill of Rights, and paying attention to nurses’ rights were the solutions proposed. Enhancing stakeholder’ s awareness and providing necessities by managers can help in the operationalization of the Bill.

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Trend towards noninvasive, easy to use monitor was always a challenge. Numerous indices have been used to monitor the progress of patients on positive pressure ventilation. The present study compares different indices in a mixed larger intensive care unit (ICU) population. In a prospective observational study Arterial blood gases (ABG) analyses were obtained from 225 patients under mechanical ventilation in a polyvalent adult ICU. Values of ideal body weight (IBW), Body mass index (BMI), PAO2, PaO2/FiO2 ratio (PFr), SpO2/FiO2 ratio (SFr), SpO2/PEEP ratio (SPr), SpO2/PaCO­2 ratio (SPCr), Oxygenation index (OI) and Ventillatory ratio (VR) were calculated; and further correlation analysis was conducted. In Pressure control ventilation mode a relative strong relation between PFr and SFr and OI was found; yet further regression analysis implies that no direct replacement of PFr with SFr can be made without limitations, in clinical setting. In Volume control ventilation mode moderate relation was found between SFr and PFr. In the present study a moderate relation was found between SFr and PFr. The results agree with previous published studies; the differences among them lie in the different design of each one of them. The authors believe that- given the fact that one still considers using broadly PFr as index of oxygenation- SFr can be used safely as a surrogate for PFr only for certain disease states. Larger series are needed in order to define those patients groups and these pathophysiological conditions.

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Access to appropriate and high quality health care is one of the most important ways to reduce maternal and infant mortality. This study evaluates the quality of care during childbirth, the effective factors, and promoting strategies in Lorestan province, Iran. This research is a mixed explanatory study (i.e., quantitative and qualitative). The quantitative part is descriptive-analytic. The quality of 200 care processes during childbirth was assessed in the health centers of the province. The data were gathered through the checklists prepared according to the guidelines of the Iranian Ministry of Health. Statistical analysis was performed using SPSS software. In the qualitative part, the strategies for solving the problem were assessed through interviews with service providers, maternity administrators, and senior decision-making university officials. According to our results, the levels of care quality during childbirth were intermediate in all four phases. The lowest levels of quality in the first, second and third stages were associated with Leopold's maneuver, hand washing and pulse control, respectively. Based on the interviews, the main reasons for the reduction of care quality include lack of staff’s motivation, overcrowding and shortage of nursing workforce, low attention of officials to the Department of Midwifery, and the high burden of writing in the maternity. To improve the quality of services, the authorities in Lorestan University of Medical Sciences propose strategies such as making some incentives for care promotion. Considering the quality of care during childbirth as intermediate in all four stages in the province and investigation of the reasons indicating the lack of sufficient incentive in midwives, it is recommended that strategies such as financial incentives, greater use of private sector to reduce public sector workload, quality increase and further use of in-service training to improve the quality of services be adopted.

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