Patient Care Problems Research Articles

What Factors Contribute to Ethical Problems in Patient Care? A Scoping Review and Case Series of Clinical Ethics Consultations.

A scoping review of ethical risk factors in patient care and a CEC case series were conducted, analyzing the documentation (consultation reports, feedback forms, electronic medical records) of 204 CECs from 2012 to 2020 at a somatic and a psychiatric university hospital in Basel, Switzerland. Ninety-nine ethical risk factors were identified in nine articles, related to four risk areas: patient (41), family (12), healthcare team (29), and system (17). Eighty-seven of these risk factors were documented at least once in the CEC case series. The most prevalent risk factors in the consultations studied were patient vulnerability (100%), missing or unclear hospital ethics policy (97.1%), shift work (83.3%), lack of understanding between patient and HCP (73.5%), poor communication (66.2%), disagreement between patient and HCP about care (58.8%), and multiple care teams (53.4%). The prevalence differed significantly by medical specialty. There are highly prevalent ethical risk factors at all levels of clinical care that may be used to prevent ethical problems. Further empirical research is needed to analyze risk ratios and to develop specific risk profiles for different medical specialties.

Pressure Injury Prevention in Adult Critically Ill Patients: A Best Practice Implementation Project.

Implementation science is the process of integrating an intervention into practice within an organization or health system and is a useful strategy to improve practice, affect patient outcomes, and promote practice sustainability. In this series, AJN and the journal JBI Evidence Implementation have partnered to deliver examples of how health care facilities from around the world have worked to solve common patient care problems. Through this partnership, we strive to create awareness and share knowledge and experiences by publishing summaries of studies that have appeared in JBI Evidence Implementation. These summaries are designed to provide nursing teams with an overview of the barriers faced and the strategies and resources needed to improve practice and drive change at the unit level. Our goal is to ensure that AJN readers have access to important evidence-based information designed to influence patient outcomes and nursing practice.-Carl A. Kirton, DNP, MBA, RN, ANP, FAAN.

Hubungan Pengetahuan Pencegahan Infeksi Dan Masa Kerja Perawat Dengan Perilaku Pencegahan Infeksi Luka Operasi Di RS Gatot Soebroto Tahun 2023

Surgical wound infection is a serious problem in patient care in hospitals. This infection can cause increased morbidity, mortality, increased length of stay as well as costs and patient demands. This can be closely related to the quality and services of hospitals, which will also affect the credibility of health services. Nurses are the people who have the most contact with patients, therefore nurses' behavior is very influential in implementing procedures to prevent surgical wound infections. This study aims to determine the relationship between knowledge and length of work with nurses' behavior in efforts to prevent surgical wound infections at Gatot Soebroto Hospital in 2023. This research method is a quantitative study with a cross-sectional design approach. Using a total sampling technique of 60 people. Data collection was carried out by assessment using knowledge questionnaire instruments and intra-operative behavior checklists. Data were analyzed univariately and bivariately using the Spearman rho test correlation technique. The research results showed that 21 nurses (35%) had less knowledge. Nurses who have worked for less than 6 years are 37%, nurses who have worked for more than 10 years are 40%. Nurses with bad behavior had a higher number of 53.3%. The results of the Spearman rho test showed that (1) there was a relationship between nurses' knowledge of the behavior of preventing surgical wound infections with a p value = 0.000, meaning p > 0.05 (r = 0.616), (2) there was a relationship between the length of service of nurses and the behavior of preventing wound infections. operation with a p value = 0.006 means p > 0.05 (r = 0.349). The conclusion is that there is a significant relationship between knowledge and behavior of nurses and there is a significant relationship between length of service and behavior of nurses in efforts to prevent surgical wound infections. The research suggestion is for hospital management to increase nurses' knowledge in the form of training, workshops and regular supervision,

Selected aspects of nursing care for a patient after ischemic stroke in a care and treatment facility - a case study

Cerebrovascular diseases (including strokes) are currently the second leading cause of death in the world [1,2]. In Poland, statistical data are quite diverse, depending on their source. Stroke patients are often at risk of chronic disability. A significant number of them are doomed to lose their independence and self-care for the rest of their lives. The aim of the study is to present selected nursing problems and ways to solve them in a patient after ischemic stroke who requires round-the-clock care in the field of nursing and care services as part of inpatient long-term care. The subject of the study is the process of nursing a patient diagnosed with ischemic stroke who requires round-the-clock care in the field of nursing and care services as part of long-term care. The study uses a research method - a case study, supported by individual observation, measurements, interview and analysis of medical records. Two scales were used to assess the patient's condition: Barthel and Norton. Conclusions: The individual care plan takes into account the most important problems arising from the specificity of the disease entity, needs and individual situation of the patient. The patient's care problems after a stroke are presented and proposed an effective solution to ensure the best possible care. Nursing and care difficulties have been properly recognized, which has enabled appropriate nursing interventions. Due to systematic prophylactic measures, the patient did not suffer from complications. A detailed interview and careful observation made it possible to plan and implementation of interventions (not only nursing) to provide comprehensive care. The urgent procedure of admitting the patient to the care and treatment facility contributed to the improvement of the quality and availability of health care services, which translated into an improvement in the patient's general condition.

Epistemic (in)justice, social identity and the Black Box problem in patient care

This manuscript draws on the moral norms arising from the nuanced accounts of epistemic (in)justice and social identity in relational autonomy to normatively assess and articulate the ethical problems associated with using AI in patient care in light of the Black Box problem. The article also describes how black-boxed AI may be used within the healthcare system. The manuscript highlights what needs to happen to align AI with the moral norms it draws on. Deeper thinking – from other backgrounds other than decolonial scholarship and relational autonomy – about the impact of AI on the human experience needs to be done to appreciate any other barriers that may exist. Future studies can take up this task.

Cardio-Oncology: Managing Cardiovascular Complications of Cancer Therapies.

This narrative review explores the complex relationship between cancer medicines and cardiovascular health in the junction of oncology and cardiology, known as cardio-oncology. The study examines the historical development of cancer treatments and highlights the growing importance of cardiovascular problems in patient care. This text delves into the topic of cardiotoxicity, examining both conventional chemotherapeutic drugs like anthracyclines and more recent tyrosine kinase and immune checkpoint inhibitors. The complex molecular and cellular mechanisms that control cardiovascular problems are explained, including an understanding of how genetic predisposition influences an individual's sensitivity. The narrative expands into the crucial realm of risk stratification and evaluation, revealing advanced instruments for identifying cardiovascular risk in cancer patients. The importance of non-invasive imaging methods and biomarkers in early detection and continuous monitoring is emphasized. The prioritization of preventive tactics emphasizes the need to take proactive measures incorporating therapies to protect the heart throughout cancer treatment. It also highlights the significance of making lifestyle improvements to reduce risk factors. The narrative emphasizes the changing collaborative treatment environment, advocating for merging oncologists and cardiologists in a coordinated endeavor to maximize patient outcomes. In addition to clinical factors, the review explores the critical domain of patient education and support, acknowledging its crucial role in promoting informed decision-making and improving overall patient well-being. The latter portions of the text anticipate and consider upcoming treatments and existing research efforts that offer the potential for the future of cardio-oncology. This review seeks to provide a detailed viewpoint on the intricate connection between cancer treatments and cardiovascular well-being. Its objective is to encourage a more profound comprehension of the subject and prompt careful contemplation regarding the comprehensive care of cancer patients who confront the intricate difficulties presented by their treatment plans.

Emergency Nurses’ Well-Being in Magnet Hospitals and Recommendations for Improvements in Work Environments: A Multicenter Cross-Sectional Observational Study

IntroductionThis study aimed to determine the well-being outcomes and quality of work environment among emergency nurses compared with inpatient nurses working in Magnet hospitals and identify recommendations in emergency department work environments that hold promise for enhancing emergency nurses’ well-being. MethodsThis is a cross-sectional analysis of multicenter survey data collected in 2021 from 11,743 nurses practicing in 60 United States Magnet hospitals. Nurses report on burnout, job dissatisfaction, intent to leave, work environment, and recommendations to improve well-being. ResultsEmergency nurses are significantly more likely to report high burnout (P = .04), job dissatisfaction (P < .001), and intent to leave (P < .001) than inpatient nurses working in the same Magnet hospitals. Emergency nurses are significantly more likely to report insufficient staffing (P = .001), an unfavorable work environment (P < .001), and lack confidence that management will act to resolve problems in patient care (P < .001) but did report significantly better working relationships with physicians (P < .001) than their inpatient counterparts. The 2 greatest recommendations to improve well-being included improving nurse staffing (91.4%) and the ability to take uninterrupted breaks (86.7%); the lowest-ranked recommendations were employing more advanced practice providers (25.9%) and appointing a wellness champion (21.2%). DiscussionHigh burnout and other adverse nurse outcomes are common among emergency nurses in Magnet hospitals. Modifiable features of ED work environments including inadequate nurse staffing, inability of nurses to take uninterrupted breaks, and lack of responsiveness of management to persistent problems in patient care warrant high priority attention by Magnet hospital leaders.

Contemporary adult gerontology acute care nurse practitioner (AGACNP) practice: Findings from the 2020 American Association of Critical Care Nurses AGACNP practice analysis survey.

National standards for nurse practitioner licensure require certification programs to conduct practice analyses to ensure that certified nurse practitioners possess the necessary knowledge for entry-level practice. The practice analysis for the American Association of Critical Care Nurses Certification Corporation (AACN Cert Corp) adult-gerontology acute care nurse practitioner (AGACNP) credential is performed every five years by the AACN Certification Corporation. The AACN Cert Corp conducted a practice analysis to confirm that current AGACNP practice is reflected in the ACNPC-AG test plan, and the examination is congruent with 2008 consensus model guidelines. This work describes findings from the 2020 AACN Cert Corp practice analysis and changes in AGACNP practice and academic preparation based on the survey data. In 2020, AACN Cert Corp volunteer subject matter experts (SMEs) developed a survey of practice activities and competencies relevant to AGACNP practice. Patient care activities and competencies were rated by AGACNP respondents for criticality and frequency. AACN SMEs reviewed criticality and frequency ratings to determine the patient care problems, skills/procedures, and competencies to include in the updated AACN Cert Corp ACNPC-AG test plan. The 2020 AGACNP practice analysis survey and subsequent review resulted in the retention of 33 skills and procedures, 165 patient care problems, and all national competencies in the final ACNPC-AG test plan. The 2020 AACN Cert Corp AGACNP practice analysis survey describes possible changes in AGACNP practice and academic preparation that have occurred since the 2016 survey, findings that may be associated with the ongoing COVID-19 pandemic.

EFEKTIVITAS PENGGUNAAN MANAJEMEN LEAN TERHADAP PENINGKATAN MUTU SISTEM PELAYANAN DI RUMAH SAKIT DI INDONESIA: STUDI LITERATUR

As a component whose benefits are expected, hospital management also focuses on the effectiveness of patient health services. By using appropriate management, problems related to patient complaints, waiting times, drug distribution to the performance of health workers can be measured. The management in question is by applying the concept of Lean. The use of the Lean concept in hospital management is proven to be able to reduce problems in patient care and even hospital organization. This also has an impact on improving the quality of the hospital concerned. This study aims to determine the effectiveness of using Lean management to improve the quality of service systems in hospitals in Indonesia. This research uses the method of literature study or Systematic Literature Review with national quality scientific journals as data. The results of the research show that the effectiveness of the use of Lean management applied in Indonesia is already going well. Hospitals benefit especially in the field of 5M (Man, Money, Material, Method, Machine) utilization.&#x0D;

Polish Adaptation of the Alarm Fatigue Assessment Questionnaire as an Element of Improving Patient Safety.

Medical personnel, working in medical intensive care units, are exposed to fatigue associated with alarms emitted by numerous medical devices used for diagnosing, treating, and monitoring patients. Alarm fatigue is a safety and quality problem in patient care and actions should be taken to reduce this by, among other measures, building an effective safety culture. In the present study, an adaptation of a questionnaire to assess alarm fatigue was carried out. The study obtained good reliability of the questionnaire at Cronbach's alpha level of 0.88. The Polish research team has successfully adapted the Alarm Fatigue Assessment Questionnaire so that it can be used in healthcare settings as a tool to improve patient safety.

Problems of medical care for patients with chronic obstructive pulmonary disease in the administrative territories of the Russian Federation

Problems of medical care for patients with chronic obstructive pulmonary disease in the administrative territories of the Russian Federation

Palliative care in the perception of families with patients oncology surgery

Introduction: The family's participation in palliative care is usually very high, especially when the patient is in hospice home care. Aim of the study: The study aimed to assess the perception of palliative care by families of oncological patients from Podlaskie Province, Poland. Materials and methods: The study included 108 oncology surgery patients' families, 50.8% women and 49.2% men, aged 40 to 80 years. The study used the method of a diagnostic survey with the use of a proprietary questionnaire. Results: 66.7% of people recognized the hospice as comprehensive care for the terminally ill patient; 74.9% of them had positive associations with the hospice; 82.4% of people believed that death was a natural phenomenon; 75.2% were against euthanasia; according to 89.8%, the information provided to the family in a hospice should be comprehensive; support in the hospice should be provided mainly by a permanent clergyman (76.4%) and people after the loss of a loved one (65.4%); the most desirable religious practices in the hospice were the mass (86.7%), rosary prayer (81.6%), confession (81.2%) and sacraments (81.2%); in the hospice showing a lot of kindness, smile and courtesy on the part of the hospice staff to patients (92.5%) and their families (88.5%); the patient should have unlimited access to a clergyman of his religion (98.8%), a psychologist (98.1%) and a physiotherapist (94.6%) in a hospice; according to 87.3% of patients' family members, the society does not pay much attention to palliative care; problems in hospice care result from the growing number of patients with chronic diseases (96.7%) and the lack of public knowledge about palliative care (92.7%); improvement of the quality of medical care in hospices would be achieved by an increase in the number of staff (87.4%) and an increase in the number of beds (82.4%). Conclusions: In the opinion of most families of patients with cancer, hospice is comprehensive care for terminally ill patients and the right place for terminally ill patients, regardless of their diagnosis. The respondents considered a permanent clergyman and people after the loss of a loved one to be the most appropriate people to provide support to hospice patients. The respondents saw problems in patient care at the end of life, mainly in the increasing number of patients with chronic diseases and the lack of knowledge of society about palliative care, its increase in the number of medical personnel, and the increase in the number of beds. The respondents considered the hospice as a place for people suffering from an incurable disease, regardless of the diagnosis, in which the patient does not feel lonely, has support, can feel safe, and as a form of care for the patient, it would be recommended to other families

Directions of development of functional missions of computer pharmaceutical knowledge bases talking into account various types of crisis situations

The computer pharmaceutical knowledge bases are effective tools of information support for the organization provision of medicines, pharmaceutical care and education of pharmaceutical specialists.&#x0D; The purpose of the work іs to substantiate the urgency of developing the computer pharmaceutical knowledge base «Pharmaceutical care for patients with diabetes» with increasing the number of the functional tasks of the information blocks of medicine provision management pharmaceutical care to patients with diabetes mellitus, didactic support of educational system of pharmacists in the conditions of various types of crisis situations.&#x0D; The objects of the study were the components of the information system about medicinal products, informational materials on the problems of pharmaceutical care for patients with diabetes mellitus during the period of the COVID-19 epidemic and the period of martial law. The methods of studying the need for information about medicines, pharmaceutical diagnostics, construction of information arrays of computer pharmaceutical knowledge bases were used.&#x0D; The following areas of expansion of the information arrays of blocks are substantiated: «Medicines» – inclusion of materials on new and classic drugs for the treatment of COVID-19; changes in the arsenal of antidiabetic drugs due to martial law; «Management of pharmaceutical care» – inclusion of systematized scientific data on the problem of specialization of information provision; «Reforming the health care system (pharmaceutical subsystem)» – adding information materials to optimize the management of the supply of antidiabetic drugs in view of the systematized measures overcoming the COVID-19 pandemic, epidemics of other genesis, anti-crisis measures in the health care system during the period of martial law; «Education of pharmaceutical specialists (postgraduate stage)» – filling with materials of provision of medicines and pharmaceutical care for patients with COVID-19 also have diabetes mellitus and during martial law.&#x0D; The structure of the computerized pharmaceutical knowledge base «Pharmaceutical care for patients with diabetes» was substantiated and the directions of its development were worked out in view of the expansion of functional tasks during the COVID-19 pandemic and martial law.

Arrangement and objectives of providing patients with lung cancer with treatment during the COVID-19 pandemic in the Russian region

The operation of the oncological services of the Russian Federation were complicated by the spread of the Severe Acute Respiratory Syndrome CoronaVirus-2, which worsened the diagnosis of lung cancer and led to the reorientation of medical institutions to the anti-epidemic mode.The aim. To evaluate the features of providing medical care for lung cancer to residents of the Magadan Region during the pandemic of COronaVIrus Disease-19 (COVID-19).Methods. The analysis of the Magadan Region database on patients with lung cancer was carried out. The databased is filled in with the information from state statistical reporting forms No.7 and No.35. General problems of the Magadan Region healthcare system were identified using materials of publications from the Medline, CrossRef, Pubmed and Scopus databases for 2019 – 2021; the potential solutions were also suggested.Results. The analysis of the incidence of malignant neoplasms in 2014 – 2020 yy. showed that lung tumors are in the lead among Magadan Region residents. The “rough” incidence rate of lung cancer in 2019 (58.8 per 100,000 inhabitants an increase from 2009 +20.74%) and the relative proportion of these tumors detected in 2020 in localized stages are ahead of the average values for the Russian Federation. In 2018 – 2021, the indicator of morphological verification of lung cancer and the proportion of advanced tumors continued to increase, but the one-year mortality rate was decreasing. In 2021, 10.3% of the residents of Magadan Region had low-dose computed tomography (CT) of the chest organs. 10 (1.8%) cases of lung cancer were detected. Localized lung cancer was detected in 32.5% of those cases (2020 – 24.5%, 2019 – 20.3%). The spread of the coronavirus infection has complicated work of the staff of the Magadan Region oncology service: remote medical consultations for patients living far from the regional center (Magadan) are to be developed. Insufficient number of low-dose CT machines in the medical institutions, understaffing in health facilities, insufficient use of chemotherapy in the treatment of patients with lung cancer, as well as problems of palliative care for patients with advanced stages of the tumor were identified.Conclusion. The main problems of the oncological service of the Magadan Region are the shortage of personnel, lack of equipment and the lack of a single information field in the medical institutions. These problems of specialized medical care for patients with lung cancer will have to be solved by the regional Ministry of Health, scientific schools, and universities.

Contributions of nurse specialists in the allergy and immunology service and patient care.

Specialist nurses have a crucial role within the allergy and immunology specialty that reflects their competence in an increasingly complex area of work and ability to use advanced diagnostic testing and therapeutic modalities. A specialist nurse in Qatar follows the local Hamad Medical Cooperation (HMC) guidelines and the competency published by the British Society for Allergy and Clinical Immunology (BSACI).Specialist Allergy NursesLearning domain: Learn and review the written standard operating procedure (SOP) and protocols for all diagnostic and therapeutic allergy procedures, including skin prick testing (inhaled, food, and others), intradermal testing, skin patch testing, penicillin testing, food and drug challenges, different desensitization protocols, and biologics and other medication administration. In addition, learn the protocol for immunotherapy administration and maintain an updated knowledge of trends and developments in the field by reading relevant articles, journals, and related material and attending seminars and conferences, as needed.Maintain a safe work environment: Perform all the above procedures and medication administration with a high grade of competency under physician supervision. Apply quality measures to ensure safety. Furthermore, perform stocktaking by regularly checking procedure requirements, availability of items and consumables, date of expiry of items, and medications. Monitor the patients closely during drug and food allergy challenge procedures and record and report patients’ vitals and reactions to treating physicians. Ensure that a patient stays the required observation time after injection(s).General care: Assess patient needs and suggest solutions to patient care problems. Provide education and resources for the patient and family support as needed. React appropriately and on time during patient reaction situations to mitigate early adverse reactions. Maintain patient, employee, and clinic confidentiality.Specialist Immunology Nurses• Develop specialist knowledge and experience in immunology.• Develop nurse-led clinics for administering immunoglobulin replacement therapy safely and effectively based on patients’ preferences (IV vs. SC and in-hospital vs. home programs).• Coordinate communication between members of the multidisciplinary team to facilitate the appropriate delivery of care.• Provide education and resources for the patient and family support (insurance issues, resources for vaccination recommendations, concerns regarding traveling and vacations, pregnancy, and any other lifecycle changes).

Investigation of poor prognostic markers in covid-19 patients hospitalized from emergency department

On March 11. 2020, the World Health Organization declared the coronavirus disease-2019 (COVID-19) outbreak a pandemic. The surge in the number of infected patients has strained healthcare systems globally. The insufficient number of hospital and intensive care unit (ICU) beds has caused a serious problem in patient care and follow-up worldwide. We determined patients who were admitted to the emergency department and hospitalized with a preliminary diagnosis of COVID-19 between March 11, 2020 and November 15, 2020. We recorded all subjects' admission vital signs, anamnesis, physical examination notes, laboratory tests and notes describing the hospital stay from the hospital information system. Patients discharged without requiring ICU admission were included in the good clinical prognosis (GCP) group. Patients who were admitted to the ICU or died in hospital were included in the poor clinical prognosis (PCP) group. When hematological and biochemical parameters were compared, white cell, neutrophil, platelet counts, glucose, urea, creatinine and bilirubin levels were significantly higher and lymphocyte count, hemoglobin, hematocrit, sodium and chlorine levels were lower in the PCP group. Moreover, sedimentation, C Reactive Protein (CRP), ferritin, High Sensitive Troponin I, D-dimer and lactate levels were significantly higher among patients with a poor prognosis. We assessed and identified the more important potential early indicators of prognosis mentioned in the literature that are applicable in the emergency setting. In light of this information, we aimed to establish a basis for the development of future scoring systems.

Nursing Care Plan for a Newborn with the Defect of Congenital Gastroschisis in the Postoperative Period Using ICNPTM and the Dedicated Software.

Background: Congenital defect gastroschisis manifests as a defect in the sheath in the intestine of the newborn, which is not covered by the hernia sac. In this case, the priority task of the neonatal nurse is to diagnose patient care problems quickly and accurately. Choosing the correct care plan elements has a significant impact on shortening the duration of hospitalization, reducing the number and severity of complications, and preventing their recurrence. The purpose of this study was to formulate a care plan for a newborn with diagnosed congenital defect gastroschisis in the postoperative period, using the International Classification for Nursing Practice (ICNPTM) within the nursing documentation and decision support system, the “ADPIECare Dorothea” software. Methods: After a review of the relevant literature and nursing documentation, a case study of a newborn with the congenital defect gastroschisis was described. A care plan was prepared using ICNP and the “ADPIECare” software. Results: It was possible to organize and standardize care plans to provide consistent and comprehensive professional nursing care. The system supporting nursing decisions suggested interventions personalized for the nursing diagnoses and to the patient needs. Conclusions: Our findings can help to optimize the nurse’s work organization to improve health care quality, outcomes, and effectiveness.

Improvement Of Caregivers Ability to Care for Patients in Mentari Hati Social Institutions Tasikmalaya

Based on Riskedas data in 2013, the prevalence of mental disorders in Indonesia is about 6% of the population has emotional disorders and 1.7% of serious mental disorders. In West Java the prevalence reaches 1.6%, while in Tasikmalaya City there are 171 sufferers. Mental disorders can be caused by biological, psychological and socio-cultural factors, it can also be caused by inadequate provision of patient care, especially in small towns and villages. Patients with chronic mental disorders need care management that involves various elements in the healing process, such as family, community and caregivers. The role of care giver which is very influential in the patient's healing process, they are in charge of providing emotional support and the necessities of life. The complex problems in patient care caused many of them not to be well cared for. One of the phenomena was found at the Mentari Hati Social Institusion. The caregiver's low educational background, and lack of knowledge in care, are among the factors causing the ineffective treatment provided. For this reason, a mental nursing service management program is needed which is managed in a Community Mental Health Nursing (CMHN) program which aims to empower caregivers by providing consultation and education services, and providing information on mental health principles. The purpose of this community service activity is to improve the care giver's ability to care for mental patients.

Severe Acute Respiratory Syndrome Coronavirus 2 Pandemic: Chilean Air Force Experience in the Air Transport of Critically Ill Patients—The First 100 Cases

ObjectiveCritical care air transport has played an important role during the coronavirus disease 2019 (COVID-19) pandemic. The goal of this article is to analyze results and lessons learned from the evacuation of the first 100 COVID-19 patients transported between medical facilities in Chile. MethodsWe reviewed prospective data of patients who were referred for air transport between March 27, 2020, and July 9, 2020. ResultsOf 115 referred patients, 100 were transported by air. All patients were intubated and mechanically ventilated. Hypertension, diabetes, and obesity were the most commonly observed comorbidities. Our service did not experience any major problems in patient care en route or among the crewmembers. We did not observe any severe acute respiratory syndrome coronavirus 2 infections among our flight team members during the study period. Twelve (12%) patients died at their destination intensive care unit, whereas the remaining 88 patients (88%) returned to their primary hospitals after recovery. ConclusionsAir transport of mechanically ventilated patients with COVID-19 infection has been shown to be a safe way of transport, with no in-flight deaths and an in-hospital mortality of 12%, which compares favorably with the in-hospital mortality of similar patients who did not undergo air transport.

POCD z perspektywy personelu medycznego i rodziny pacjenta

Objective: Review of studies in topostoperative delirium and problems of the family of the patient affected by an episode of postoperative delirium. Method: literaturę review, work supported with research examples. Delirium (acute cerebral syndrome) is a set of disorders of consciousness including hallucinatory syndrome, delusional syndrome and psychomotorexcitation. It usually occurs on day two after surgeries and affects 2.5–3% of alloperated patients. It i salso one of the reasons for extending hospitalisation time, increased treatment costs and even increased mortality rate. The risk factors include the type of surgery (most frequently femoralneck repair), high ASA score (3 and more), history of cardiologic, respiratory, neurologic and metabolicdiseases, sensory deficits, postoperative pain, polypharmacy, fluid starvation and preoperative pain. There have been no management recommendations so far – both pharmacological and non-pharmacological – that would be effective in prevention and treatment. The main directions include elimination or minimisation of the risk factors. The family of the operated patient is in a difficult situation as they have to face not only the problems that might be expected before the surgery, but also with the additional disorder that occurs by complete surprise. The condition not only leads to terror and anxiety due to its nature, as the patient after the surgery may see manentirelyalien person, but it also marks the beginning of additional problems in patient care.