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Vol. 19. No. 1 FEBRUÁR 2006 |
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| NURSING MANAGEMENT | The use of disease categories to judge the condition of patients
Leviczky Z. A new approach to manager selection
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| HUNGARIAN SCIENTIFIC SOCIETY OF NURSING | The nurse as health promoter
Németh K., Dér A., Pakai A. |
| OUTLOOK | Health visitor's work possibility are in the prevention of postnatal depression
Csatordai S. The past and present of nursing professional supervision
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The use of disease categories to judge the condition of patients
Assessing the actual treatment needs of patients, and accurately determining the human resources required for their care, both represent a considerable challenge for nursing management. A common problem is that nurses are exhausted and overworked, even in cases where staff numbers meet the statutory requirements. The aim of my research was to reveal, based on a case study of the departments of the Szent Imre Hospital Operative Professions Matrix Institute, how suitable the Hungarian application, of the treatment needs-based patient-categorisation method, adapted from the German model, is for the measurement of nursing performance (and nursing staff overload). The study was performed between 1 January and 30 June 2005. Based on the number of minutes allocated to each disease category, it is possible to calculate how much time the nurse needs to spend with the patients. The extent to which these targets are actually met can also be established. The results clearly show that nurses are unable to spend as much time with the patients as would be required based on their condition. It is nurses that have to bridge the gap between the statutory regulations pertaining to minimum levels and the expectations regarding the optimal care of patients.
The author examined the selection process for filling senior nursing positions. In Hungary today, there are no uniform procedures for manager selection in healthcare, and institutions do not use aptitude testing systems based on objectivity. With the aim of rectifying this situation, the author presents a "sample package," which should also be of special interest to senior managers. The "sample package" is a model that can be applied during manager selection, and which could support, facilitate and ease the process of making a responsible and correct decision.
Objectives of the study: Testing and effectiveness-study of a programmed patient education program lasting three nursing days - with a proprietary patient education pamphlet and documentation guidelines - on patients recovering from myocardial infarction. The aim was to assess how, in comparison to the presented alternative, nurses' health promotion activities are performed in respect of the affected patient group.
Research method and sample: The study was conducted in the cardiological rehab units of two county hospitals. Specialist and general nurses volunteered to test programmed patient education programs on 30 patients recovering from myocardial infarction.
The sample was drawn from a limited pool of staff, and is therefore not representative, but in our view is suitable for a study of tendencies.
Results: In the case of the studied sample, our working hypothesis was borne out. Health promotion activities are not planned either thematically or methodologically, are "ad-hoc" in nature, and inadequately documented.
After the three-day programmed patient education course, the patients' cognitive knowledge of myocardial infarction, its treatment and lifestyle-related indications had improved 20% compared to before the course. Thus we were able to measure the effectiveness of programmed patient education on the cognitive plane.
Conclusions, recommendations: Today, education-oriented, authoritative health promotion is increasingly being replaced with an interactive, dynamic work process, based on the active participation of the patient. In the case of patients and clients who are resistant to these changes, compliance is reduced. As nurses, we have an important role to play in health promotion, a fact that is clearly demonstrated by this study.
The aim of my investigation, the signs of aspect are solved during the pregnancy by the Leverton Questionnaire (LQ), that is demonstrated inclination to postpartum depression; and the relative incidence of postpartum depression is reduced by the psychotherapeutin group discussion for "vulnerable" pregnant women; the prevention procedure is treated, and is planted to the health visitor practice.
The investigation has accompished in the 4 counties of the south region of Hungary between 2001-2003. We have taken samples of 680 participants in the beginning of the pregnancy, then have repeated during puerperal period.
Accordingly my previous results, maters concerned more than half for depression mood.
The serious somatic symptoms occur relatively rare, but the investigated pregnants often felt to great extent tired.
In our investigation 570 (83 %) pregnant women get to vulnerable group, that showed above 10 points during first and second trimester of the pregnancy. We repeated Leverton Questionnaire in the end of the puerperal period, without so much as psychotherapy intervention would happen.
In future, we will suggest that instructional meetings for vulnerable gravids in the scope of 4-5 hours group discussion according to first trimester results. Psychiatrists and methal health visitors will conduct these meetings.
The author reviews the individual stages in the formation and development of the Hungarian system for the professional supervision of nurses. The article includes an account of the changes that have occurred, and a detailed analysis of the structure of nursing monitoring activities, the duties and available resources. It outlines the likely direction for future development, the necessary steps and future tasks of the organisation.